Democrats could lose to Trump if they abandon Obamacare and private health insurance

Iowans have an extraordinary opportunity to shape our nation’s history through the caucuses that launch the presidential nomination season on Feb. 3. The rest of America is counting on the seriousness with which they have always approached the responsibility that comes with their pivotal role in presidential selection.

For Democrats, it is critical to focus on our core health care principles. Universal access to affordable health care must be a core principle. No one should be denied life-saving care because of the size of their paycheck. Justice demands an effective and achievable way to get it done soon.

We lost a family member for lack of health insurance. With no coverage, she rarely saw a doctor. By the time her cancer was discovered, she had less than one month to live. The system that caused her death is wrong. It violates progressive principles. It violates Christian principles and those of most religions.

Different paths to health care for all

Changing that unjust system must be a priority. But there is more than one way to get it done. European countries have achieved universal access to care through a variety of means. They include single-payer coverage similar to Medicare for All and regulated private insurance with subsidies for those who need them, similar to the Affordable Care Act.

The Affordable Care Act was a historic first step toward the universal access to care sought by American progressives for over 100 years. It was initially unpopular, enabling its Republican opponents to take over Congress by painting it as a threat to the coverage of those who had insurance.

Seventeen Democratic candidates attended the Polk County Steak Fry on Sept. 21, 2019 in Des Moines, Iowa.
Seventeen Democratic candidates attended the Polk County Steak Fry on Sept. 21, 2019 in Des Moines, Iowa.

But it has stood the test of time. Today, it is supported by most Americans because it has extended health coverage to many who needed it without the dire consequences its opponents predicted. It has transformed lives for the better.

The law did not achieve universal access to care in one step. But it can get us there with some critical fixes such as Medicare for those who want it, relief from expensive co-pays, negotiation with drug companies and other means to drive down costs.

Historic legislation always requires refinements based on initial experiences. That is especially the case for the Affordable Care Act because it has been actively undermined by the president and Congress. Nevertheless, it provides a solid foundation for bringing health care to all Americans.

Don't damage chance to beat Trump

But there will be no advance for at least five years unless there is a change in the White House. And prospects for that change will be undermined if Democrats nominate an advocate of an unpopular mandate to abolish private health insurance, such as Medicare for All. By almost two to one, it is opposed by swing voters in the handful of key states that will decide the election.

Even if that electoral handicap were overcome, it would be extraordinarily difficult to pass such a mandate through the Senate. Many of its members, including many Democrats, must run for reelection in states where most voters prefer to keep their private insurance.

It would be a profound mistake to walk away from the now widely embraced Affordable Care Act for a deeply unpopular alternative. It would make it more difficult to win health coverage for all Americans and likely delay its achievement for years. At this critical juncture in history, it would add a significant barrier to the most critical step in progress toward that end — change in the White House.

Chuck Hassebrook was the 2014 Democratic nominee for governor of Nebraska and is the former executive director of Nebraska's Center for Rural Affairs. This column was originally published in the Des Moines Register.

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This article originally appeared on Des Moines Register: How to lose 2020: Scrap ACA, pledge to kill private health insurance