One woman’s to-do list for 2018

Protect the ACA and elect more women to office

I’VE BEEN THINKING ABOUT where to focus my work and energy in 2018.  I participated in the Women’s March last month, and was energized by the massive coming together of so many women and men who want to make change, as well as protect the gains we’ve made, like expanding health care coverage through the Affordable Care Act (ACA).

I care deeply about these issues.  I have been working on finding ways to provide better health care coverage for the majority of my career. But this past year has been my most challenging.

This happened for a combination of reasons.  The first was the assault on the ACA, which was relentless.  The constant male-led barrage from D.C. politicians was something I couldn’t avoid, personally or professionally.  Who can forget these images of men making health care policy that would have far-reaching implications for women?

And there was the frustration of having no decent policy alternatives to the ACA be able to gain any traction.  We got to watch Susan Collins, a knowledgeable, moderate Republican senator from Maine, be shut out of leadership’s crafting of health reform alternatives.  How could she not be at the table?  She and Sen. Bill Cassidy of Louisiana had proposed a practical alternative, which would have allowed states to craft their own solutions as long as they met the goals of the ACA.  This pragmatic approach was all but ignored.

2017 was also challenging on a personal level.  Health care issues hit my family hard.  I was diagnosed with breast cancer.  My 80-year-old mother fell, was hospitalized, had surgery, and was diagnosed with dementia.  My 18-year-old daughter suffered terrible stomach pains and ongoing weakness which turned out to be celiac disease.

Each episode has required a tremendous amount of engagement with the medical system, as well as support from friends and family.  We managed to get through and are making a fresh start in 2018.  That said, we now all have “pre-existing conditions,” and my daughter and I join the 51 percent of the non-elderly population in that category.

Throughout this, we were very fortunate to have robust health insurance coverage. Without it, our college savings would have evaporated.  We are grateful.  At the same time, we know many people do not have the coverage that we enjoy.  I strongly believe that everyone should have access to affordable health insurance.

Fortunately, the ACA still stands.  And for the reasons I’ve shared, it is phenomenally important that we protect the key tenets of what remains:

• “Guaranteed issue” of insurance so that people with pre-existing conditions can get coverage, no matter what.
• “No medical underwriting,” so that the cost of insurance coverage for people with pre-existing conditions does not become prohibitively expensive.
• Coverage of “essential health benefits,” so that the insurance you have actually covers the conditions you may have.
• A ban on annual and lifetime benefit payment caps.
• Subsidies so that working people who don’t have employer sponsored insurance can afford decent insurance.

Unfortunately, protecting the ACA from further erosion takes energy away from the work we could be doing to move toward universal coverage.  But this is where we are, and this is what we must do.  I am dedicating a portion of my time in 2018 to educating people about the ACA and protecting what remains.

Meet the Author

Rosemarie Day

President, Day Health Strategies
I will also be working to get more women elected to higher office.  While not a panacea, women are deeply connected to the health care system, often in personal ways – they are still the majority of primary caregivers and health care deciders in their households.  They can and need to translate this to the political and policy level.  We need to get say :  “Who needs maternity coverage or mammograms?”

Rosemarie Day served as one of the founding leaders of the Massachusetts Health Connector.  Prior to that, she served as the chief operating officer for the Massachusetts Medicaid program.  She is currently the president of Day Health Strategies.  Follow her on Twitter:  @Rosemarie_Day1