Short-Term Defense, Long-Term Transformation

A reflection on the state of health care defense at the end of 2017


Jen Bersdale
Executive Director
Missouri Health Care for All

December 7, 2017: In the past year, we have seen attempts to roll back, cut, or repeal health care programs from the Missouri General Assembly to the Governor’s Mansion, Congress, and the White House. Health care supporters have worked hard to resist these cuts.

Increasingly, I am being asked: Has any of it mattered? Sure, we stopped SB 28, Missouri’s attempt to slash Medicaid funding. Sure, we stopped the multiple federal attempts to repeal or gut the Affordable Care Act. But thousands of Missourians lost their prescription drug assistance or their in-home services. And Congress is on the verge of passing a terrible tax bill that will trigger cuts to health care.

Here is my unequivocal answer: YES. Our work has mattered greatly. In this landscape, it was highly unlikely that we could stop all cuts. However, we stopped far, far more than many people thought was possible. A year ago, Congressional leaders were promising to have a bill repealing the Affordable Care Act on President Trump’s desk in January.

Maintaining perspective on what we have won, and lost, matters greatly. It is absolutely true that the tax bill is terrible. It will cut health care for working people in order to fund high tax cuts for those who least need them. We should fight this bill, and we should hold those who support it accountable.

However, even if Congress passes the tax bill, it does not negate the importance of our wins earlier this year. In fact, a strong case can be made that the damage from the tax bill will be both smaller and more easily reversible than the Affordable Care Act repeal bills would have been. As David Leonhardt points out in the New York Times, the U.S. has a long precedent of cutting, and then raising, taxes on the wealthy. On the contrary, there is almost no precedent for creating a major social program like the Affordable Care Act and then taking it away from people. In addition, radically changing the rules of the insurance market and completely remaking the way Medicaid is funded would have been far harder to undo. Leonhardt writes, “The repeal of Obamacare would have haunted any future effort to improve life for middle-class and poor Americans. The passage of a big tax cut for the rich will not.”

Meanwhile, Congress’ attempt to rush the passage of deeply unpopular legislation and the grassroots organizing work of groups like Missouri Health Care for All are creating a more fertile field for positive improvements to health care than we have seen in years. The Affordable Care Act is more popular than it’s ever been. Millions have gotten active because they believe their neighbors should have health care.

Our policy victories this year, and the surge of support for health care we have helped to cultivate throughout the state, make it clear that our work does matter. By keeping one eye on short-term defense and another on long-term system improvement, we will continue to grow our impact. I am deeply grateful to you for being part of this movement.

Follow the link below to read Leonardt’s editorial:

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