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Top Issue Tuesday - The Affordability and Accessibility of Health Care

Contributed by Victoria Dinov, New Voters Communications Intern In the upcoming elections, health care costs and coverage are at the forefront of many youth voters’ minds. Unlike the many wealthy countries that have universal health care, the United States still relies on private health insurance. This situation leaves many Americans uninsured, paying exorbitant costs for access to necessities like check-ups, dental appointments, and medication. As a result, politicians have worked to come up with many different solutions. Weighing the healthcare and economic pressures carefully, some legislators argue for universal healthcare while others argue for a more gradual increase in coverage. In the 2018 midterm elections, healthcare was the second-most important issue for youth voters aged 18 to 29 years old. The Fall 2019 Harvard Youth Poll reflected this trend: 38% of the young Americans polled stated that they support “eliminating private health insurance companies so that all Americans receive health care coverage from the federal government.” A poll by the Center for Information & Research on Civic Learning and Engagement at Tufts University found that 12% of youth identified health care access and affordability as their top voting issue going into the 2020 general election. This result made health care one of the top three most-important issues for registered youth voters this cycle, along with climate change (13%) and racism (12%). 

Health Care Statistics

  1. In 2018, 8.5% of the population, or 27.5 million Americans, were uninsured

  2. Young adults aged 19 to 25 had the highest uninsured rate of any age group, according to the 2018 Census Bureau statistics.

  3. The majority of the population under 65 has private health insurance (65.1%).

  4. Of the subtypes of health insurance coverage, employer-based insurance is the most common, covering more than 55% of the population.

  5. Of the 34 Organisation for Economic Co-operation and Development countries, the United States provides the fourth-least healthcare coverage, behind Chile, Turkey, and Mexico. 

  6. In 2016, the density of medical doctors in the U.S. was 2.59 physicians per 1,000 people, far lower than the numbers in most comparably wealthy countries.

  7. Childhood immunization coverage in the United States is worse than in most other high-income countries, with the U.S. vaccination rating the third-lowest among the OECD countries.

  8. In 2017, U.S. healthcare spending increased 3.9 percent to reach $3.5 trillion, or $10,739 per person.

Many Possible Solutions There are many different healthcare proposals out there. Some plans provide universal coverage. 2020 Democratic Presidential candidate and independent Vermont Senator Bernie Sanders is famous for his Medicare for All plan, which entails universal coverage on the basis of treating healthcare as a human right. The plan expands Medicare coverage to include dental, hearing, vision, mental health, and maternity care. In addition, it increases price regulation for pharmaceutical companies by making sure Americans are not paying over $200 a year for medicine they need to survive.  Sanders’ health care plan is based on a single-payer system, in which one entity (usually the government) is responsible for paying all health care claims. Single-payer systems are highly controversial, as many people think they are disastrous for the economy and undermine private insurers. 

Another option is known as a two-tier system. In this system, the government provides basic health care for all and secondary coverage for those that can afford a higher standard of care. 

Despite the popularity of these plans, many Americans feel that the debt America will endure if they are enacted is not worth the economic risk and advocate for private health insurance plans. These plans would defend a more privatized and employer-based healthcare system. Plans based on privatized health insurance do not leave out all federal funding, however. Many of these plans actually create block grants for states. These block grants are sums of money converted from current federal health spending programs and given to states to help fund state-respective healthcare initiatives. These plans would allow for state-driven policymaking, increased consumer choice, and significantly reduced government spending. 

What the Youth Can Do It is important for youth to educate themselves about the various health care proposals. Reading up on the pros and cons of each plan allows voters to make more educated choices about an issue will have an immense impact on their futures. After this self-education, the youth must vote in elections in order to allow the various plans to come to fruition. 

Legislation That Involves Healthcare

  1. The Affordable Care Act, also termed “Obamacare,” is the nation’s most sweeping healthcare legislation this century. The ACA extended healthcare to 20 million Americans, and created a more affordable health care system overall. Among its many provisions, the ACA prevents insurers from refusing to cover people with preexisting conditions, it provides low- and middle-income purchasers with subsidies to make insurance more affordable, and it reduces the out-of-pocket expenses for low-income Americans. 

  2. In a proposal for affordable, personalized care, conservative legislators devised a plan which continued to protect coverage for those with pre-existing conditions. This framework utilized the Obamacare funding for subsidies and converted it into state-run insurance pools and Medicare block grants. These grants are distributed to states to help low-income Americans pay for their health care. Through this plan, health savings accounts were also boosted, which allowed Americans to save tax-free money for health-related expenses. 

  3. Medicare for All is a plan for a single-payer system that would provide everyone in America with comprehensive health care coverage. This plan would drastically reduce nearly every healthcare cost for individuals, including premiums, deductibles, copays, and even prescription costs. The plan also expands Medicare coverage to include dental, hearing, vision, mental health, reproductive and maternity care costs. 

  4. The American Health Care Act of 2017 is another plan that provided for expanded health care plans. Introduced by House Republicans, this plan retained provisions from the ACA that allowed people up to 26 to stay on their parent’s healthcare insurance, provided subsidies for premiums based on income, and continued state-funded community health centers. This plan halted also gave states the options to restrict healthcare based on employment and/or opt out of providing the ACA’s benefits. 

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