“Your money or your life!”
That always got laughs for Jack Benny, whose cheapness was essential to his shtick. When an armed robber announced a stickup and repeated the threat, Benny said: “I’m thinking it over!”
The classic radio skit is a serious present-day crisis for many Americans, and it’s about to get worse.
Some 27 million Americans already have no health insurance, according to the Census Bureau’s count last year.
Now, nearly 23 million more insured under the Affordable Care Act (ACA), popularly known as Obamacare, are in immediate jeopardy of having to pay sharply increased premiums that would price many of them out of that last-resort market.
Florida hit hardest
The loss of their existing supplemental subsidies from the Biden years will hit nowhere as hard as in Florida. Twelve of our 28 congressional districts are among the top 15 in Medicare enrollments, and South Florida is particularly vulnerable.
All told, more than 1.1 million Floridians could lose health coverage next year, according to the minority staff of Congress’ Joint Economic Committee. Most of it is Obamacare disenrollment. A small part would owe to Medicaid cutbacks imposed by President Trump’s cynically mistitled One Big Beautiful Bill Act.
Florida is one of nine states, mostly in the South, all run by Republicans, that didn’t expand Medicaid to more working people under the ACA.
This is what the federal government shutdown is all about. It’s the only leverage available to the Democrats, the only party devoted to health care, to try to force Republicans to extend subsidies set to expire Dec. 31.
But Republicans demand that Democrats agree to fund the government and end the shutdown before they’ll even talk about subsidies. That calls for more trust from Democrats than the ruling Republicans have earned.
One path to a solution
An obvious way to break this four-week impasse is to have the House return to pass a single bill temporarily extending funding for both the government at large and the subsidies. But Speaker Mike Johnson seems to dread doing anything that President Trump doesn’t tell him to.
Trump so far is exploiting the shutdown to blame the Democrats. But polls show that it’s narrowly working against the GOP.
Seventy-some nations have some form of universal health care. They include Canada, Mexico, all of Western Europe and South America. The U.S., alone in the developed world, does not accept health care as a fundamental human right.
Our Medicare is universal single-payer coverage only for people over 65, which was achieved only after a multi-generational struggle. Medicaid is single-payer for some of the poor — not enough.
Extending Medicare to everyone is so far beyond the wisdom and courage of Congress that Obamacare is the best they could do, and then only barely.
Millions more ‘go bare’
The Congressional Budget Office estimates that some 2 million Obamacare enrollees will be uninsured next year, and as many as 3.8 million will “go bare” by 2035 if Congress does not extend supplemental subsidies for people who buy their own policies through Obamacare marketplaces.
It’s especially heavy in those 12 Florida congressional districts that rank among the 15 nationwide where people depend most on Obamacare.
The looming crisis will be most severe in South Florida.
Miami-area Rep. Maria Salazar’s 27th District leads the nation with 38% Obamacare enrollment. Close behind are her Miami Republican colleagues Carlos Giménez with 36% and Mario Diaz-Balart with 30%.
In raw numbers, Diaz-Balart’s 26th District reportedly has more Obamacare enrollees, some 300,000, than any other House member.
District by district
Other Florida Obamacare percentages in the top 15: Democrats Frederica Wilson of Miami, 35%; Darren Soto of Kissimmee, 30%; Maxwell Frost of Orlando, 29%; Debbie Wasserman Schultz of Weston, 28%; Jared Moskowitz of Parkland, 26%; Sheila Cherfilus-McCormick of Miramar, 25%; Lois Frankel of West Palm Beach, 21%.
In Republican Byron Donalds’ Naples-based district, 19% of his constituents depend on Obamacare, yet the candidate for governor is one of its most ardent critics.
The Republican Party hasn’t given up on repealing Obamacare, which survived during Trump’s first term only by the grace of the late Republican Sen. John McCain. Now, their consultants tell them that Obamacare is so popular that repeal would be suicidal, so they are now trying to destroy it without saying so, piece by piece.
The expiration of subsidies is part of that strategy.
Ron DeSantis is no help. He, his wife (a cancer survivor) and their three small children are conspicuous beneficiaries of good government health insurance, but Florida’s governor says people under 50 need only catastrophic plans that cover major illnesses and accidents — not preventive care.
That notion is as irresponsible as his administration’s anti-vaccine policies.
People under 50 do die of treatable morbidities like heart disease and diabetes. Many who die of them later could have been saved by diagnosis and treatment earlier in life.
Obamacare, with its imperfections, is a wise program on which the lives of millions of Americans depend.
A major schism between our two political parties is the simple but profound question of whether health care is a human right — or a privilege reserved only for those who can afford it.
The Sun Sentinel Editorial Board includes Opinion Editor Steve Bousquet, Deputy Opinion Editor Dan Sweeney, editorial writers Pat Beall and Martin Dyckman and Executive Editor Gretchen Day-Bryant. To contact us, email at letters@sun-sentinel.com.