As this goes to press, it's not yet clear whether House Republicans will force the federal government into a shutdown as part of their misguided efforts to delay the further implementation of health care reform. The GOP's tea party caucus has shown such an utter fixation with the cause that it's difficult to envision them abandoning it without inflicting considerable pain on the American people — at least enough to cause party moderates to rise up in protest.
For these opponents, the term "Obamacare" has become such an unthinking pejorative — akin to "communist" or "illegal immigrant" for many in the same circle — that they seem ready to blame it for every imaginable ill that can befall a human being. It is all too easy to forget that, at its heart, Obamacare is merely an effort to expand health insurance coverage for more Americans whether through mandates or subsidies.
What's especially frustrating about this showdown is that health care reform's antagonists — and even average, everyday Americans who have been made fearful of the law by the constant caterwauling by conservatives — can see Obamacare in action, successfully, a short distance from Capital Hill. Here in Maryland, Oct. 1 has been viewed not as some fearful inevitability but a moment of opportunity embraced by political leaders as well as by doctors, hospitals and other health care professionals — and many employers, too.
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This is the date that anyone can sign up for coverage through a health insurance exchange. That's it. Your employer doesn't provide you with coverage? Self-employed and looking for better coverage? Here's a list of policies and providers with prices; choose the one that fits your needs by Dec. 18 for coverage that begins Jan. 1. For many people, it's really about as simple as that. Tens of thousands of low-income households will also become eligible for Medicaid coverage for the first time; many more will qualify for subsidies. Most Marylanders won't have to bother at all as they are either covered by employer plans or by Medicare.
In Maryland, the biggest challenge has been in reaching out to the estimated 800,000 uninsured and educating them about the Maryland Health Connection and how to go about signing up for coverage. Whether that effort has been successful won't be known for weeks. Enrollment is expected to be light initially but to grow in November and December when the public is no longer distracted by the hubbub in Congress.
There is much misinformation to overcome, a lot of it generated by partisan opposition that has purposely twisted all information regarding health changes and Obamacare to put them in the worst possible light. The reality is proving quite different. Maryland's health insurance costs under Obamacare have proven lower than expected. For those who are projected to pay more for insurance under the law, it's inevitably because they are getting more than they do today, often lower deductibles and more comprehensive coverage.
Maryland's efforts are paying off, in large part because the state wasn't actively working to sabotage the concept from before the start. Nor did state officials look to score blatantly partisan Democratic points either — by, for instance, passing a law to penalize employers who force workers into part-time status to avoid the insurance mandate. Health Secretary Dr. Joshua M. Sharfstein and others determined early on that it was better to take a wait-and-see approach than to assume well-meaning employers will act so flagrantly against the interests of their own workers.
It's also perhaps unfortunate that President Barack Obama has chosen to return the shrill anti-Obamacare volleys with some heavy-handed salvos himself. In his appearance last week at Prince George's Community College in Largo to promote the marketplaces, he used terms like "crazy" and "hot air" to describe the opposition. Better to simply show them wrong — by pointing to the millions of Americans who stand to gain decent, affordable health care insurance for themselves and their loved ones who are no longer encumbered by pre-existing medical conditions or other roadblocks to private coverage.
Maryland is proving that instead of actively working against Obamacare, diligent efforts to work within the system pay off — with some of the lowest insurance rates in the nation. There is no train wreck coming down the tracks in the Free State but an opportunity that begins today for more insurance coverage, a healthier populace and maybe even a modest application of brakes on the nation's rising health care costs. That House Republicans would work so self-destructively to prevent such public benefits from going forward defies belief, yet the ridiculous drama in Washington continues, shutdown or no.