Produced in collaboration with PNHP and numerous other Medicare for All coalition partners. Download the full report HERE.
By Hebah Kassem
Congressional Progressive Caucus Center, March 2021
We’ve learned the hard way during this pandemic that America’s health care system is totally unprepared to handle a national public health crisis. Sick people have gone without testing and treatment, and health care workers have been infected because of inadequate personal protective equipment (PPE). More than a half-million people have died in the U.S. from the coronavirus pandemic. In the richest nation on earth, it doesn’t have to be this way. We can do so much better.
How was the United States health care system so dreadfully unprepared for a pandemic? It didn’t happen by accident. Powerful for-profit insurance companies have insisted for decades on maintaining our broken-down health care system because it is working exactly as they want it to—churning out exorbitant profits for health insurance and pharmaceutical companies while patients and their families pay the price.
Instead of promoting equity in health care access and outcomes, our health care system picks winners and losers. The winners profit off illness, and the losers are people who are uninsured or underinsured—unable to get affordable health care when they need it. Although the Affordable Care Act (ACA) increased the number of insured people by 20 million, nearly 87 million Americans were still uninsured or underinsured before the pandemic. This lack of insurance is all the more tragic as an analysis by Public Citizen found that “about one-third of COVID-19 deaths and 40 percent of infections were tied to a lack of insurance.”
Today, nearly half of Americans still rely on their employment for their health care coverage. The precariousness of tying health care to employment is painfully obvious after the period of epic job loss we’ve recently experienced. With almost 26 million workers suffering negative consequences including losing their jobs, having hours or pay cut, or dropping out of the labor force during the pandemic, millions of families are also threatened with the loss of health care just when they need it most.
As a result of systemic racism, people of color are far more likely to be uninsured, more likely to work in frontline jobs, and more likely to contract COVID-19. Currently, more than half of America’s uninsured are people of color, and people of color contract and die from COVID at higher rates than white people. Systemic discrimination in the economy means that people of color are more likely to be employed in dangerous jobs or jobs that do not offer living wages or adequate health insurance. The same systemic racism also means that families of color are more likely to live in health care deserts where high quality health care is not accessible.
Immigrants, in particular, have difficulty accessing health care in America’s for-profit system. As of 2017, an estimated 10.5 million undocumented immigrants in the U.S. accounted for about three percent of the total U.S. population. Many immigrant families in the U.S. include people with mixed immigration status—both undocumented and lawfully present immigrants—and those families’ access to health coverage is often uncertain or unreliable.
About 45 percent of undocumented immigrants currently lack health insurance because they are not eligible to enroll in coverage options. At the onset of the pandemic in February of 2020, the Trump Administration issued the Public Charge rule in an effort to identify and prevent any person who may depend on government benefits, including health coverage, from applying for visas and/or lawful permanent resident (LPR) status. This policy change made it even harder for undocumented immigrants to get health insurance coverage. On March 9,2021, the U.S. Citizenship and Immigration Services reversed this policy and announced it will no longer enforce the Public Charge Rule after the Biden Administration stated it will not defend the regulation issued by the Trump Administration. Although this change was welcome, it was too little too late, as the health of some immigrant families became irreparably damaged.
The Trump Administration’s decisions to slash necessary funding, delay testing, deny access to health care, block public safety measures like workplace safety standards, and downplay the severity of the COVID-19 crisis, have made our dysfunctional health care system even more vulnerable. From the beginning of this pandemic, public health experts,including Dr. Anthony Fauci, urged social distancing and quarantines in an effort to slow the spread of COVID-19 and keep everyone safe. For months, public health experts, lawmakers, and advocacy groups called for sufficient and adequate PPE to keep essential workers protected while they are risking their lives to keep us all safe. Additionally, experts called for a mass testing and contact tracing program to help control the spread of the virus, keep our hospitals from being overwhelmed, and rebuild and reopen our economy safely in accordance with the latest public health and science.
The U.S. failed to take these measures and, as a result, the U.S. set record-high numbers in new COVID-19 cases and hospitalizations time and time again. As the summer months ended and autumn began, the U.S. experienced a record high number of new cases—on Friday, October 30, 2020, the U.S. reported 99,321 new cases in a single day breaking a global daily record. As of early November 2020,nearly 50,000 people were hospitalized due to the fall surge. The number of COVID-19 cases and deaths continued to rise as we approached the winter months and millions of people traveled over the Thanksgiving break. On December 1, 2020, the U.S. recorded its 12 millionth COVID-19 case and as experts anticipated, we experienced a post-Christmas COVID surge after holiday gatherings took place across the country and a record 300,000 cases were reported on January 8th, 2021. Since then, three COVID-19 vaccines have been authorized for use and as of March 17, 2021 more than 113 million doses have been administered. Although people are hopeful, the virus is still very much here and continues to spread throughout the nation.
Everyone deserves access to the care and medication they need to survive. Long before the pandemic, high drug prices meant everyday Americans were forced to choose between paying for their prescriptions or paying their mortgage. Now, the problems Americans already face with the current health care system are being exacerbated by COVID-19 as millions contracted the COVID-19 virus and mass layoffs caused by the pandemic forced tens of millions of people to lose their employer-sponsored health insurance. No one should have to resort to begging on GoFundMe to afford life-saving care because they lost their job due to a global pandemic. We need guaranteed, comprehensive, high-quality medical care for every person at every hospital and doctor’s office. And that means Medicare for All.
Medicare for All would address the many holes and gaps in our current health care system and ensure everyone has guaranteed access to comprehensive health care regardless of income, ZIP code, or employment status.