Valley Voices

Health insurance facelift requires a scalpel not an ax

Tom Bohigian, former state director for Sen. Barbara Boxer, says as the new administration and Congress prepare to chloroform the Affordable Care Act, it is important to look at the broad picture of our fellow Americans. More than 20 million Americans who did not have health insurance before the ACA now do.
Tom Bohigian, former state director for Sen. Barbara Boxer, says as the new administration and Congress prepare to chloroform the Affordable Care Act, it is important to look at the broad picture of our fellow Americans. More than 20 million Americans who did not have health insurance before the ACA now do. Fresno Bee file illustration

As the Trump administration and the new Republican-controlled Congress proceed with repealing the Affordable Care Act, with little idea of what happens next, my memories traveled back to a Saturday morning in 2010, when I found myself standing in front of the grocery store meat case pondering what to buy for dinner.

Up stepped an acquaintance. After exchanging pleasantries, he looked into my eyes and asked, “Tom, are we becoming a socialist country?” He knew that I worked for Sen. Barbara Boxer, and Congress recently had passed the Affordable Care Act (Obamacare).

I told him, “Heck, we didn’t even get a public option to allow increased competition with insurance companies.” I then said, “Look, I know a guy who takes a couple of drugs, Lipitor and Toprol, to help deal with his heart condition. Under the old system, he would have a pre-existing condition. If he lost his job and couldn’t maintain COBRA benefits, a new insurance company could decide not to cover him for that sort of problem or likely at all.”

Then I asked, “Do you know who this is?”

He said no. I told him it was me, and asked, “Isn’t it better for someone to get proper health care, keep working, pay their taxes and live their lives in the best of health?”

I got no argument. The fact is that this sort of thing used to happen all the time. I have a close relative, a married mother who lost her job during the recession in 2010. She couldn’t afford to maintain her insurance through COBRA, but went to the same insurance company to try to get an individual policy.

Otherwise healthy, she had asthma – like so many Valley residents. Indeed, about one in five Valley children has been diagnosed with it. After about six months of bureaucratic back and forth, they turned her down for coverage because of the asthma. By 2011, with the ACA in full effect, she got a good policy so that she and her family could have peace of mind.

Back to my friend. At this point, I still hadn’t gotten the chicken or pork yet, but I asked him, “Are you on Medicare?”

He said he was 62, and couldn’t wait to get coverage. So, I asked, “What is Medicare but a government-administered health care program, primarily with private doctors, hospitals and care providers with a very low overhead? And probably one of the best things America has done for its people in history.”

We agreed on that, and parted civilly. I think I bought a roasting chicken.


I have so far had a good life, have worked nonstop since college, only now retiring for at least a while. I own my own home, have always had a comfortable place to sleep. I’ve never been hungry, and always had good health care. My health care always has been there. I cannot imagine what a person goes through when they or their child or loved one gets sick and can’t get the proper care.

It’s bad enough if it’s an ear infection for your kid, or some other malady that can be treated easily. And the emergency room should be used only for an emergency.

Primary use of the emergency room was never an intelligent health care policy, fiscally or socially. And what about cancer, multiple sclerosis and countless other diseases that afflict so many and can go on for years?

Before the ACA, a lot of people had no real options to deal with everyday health problems, much less a catastrophic situation.

As the new administration and Congress prepare to chloroform the ACA, it is important to look at the broad picture of our fellow Americans. More than 20 million Americans who did not have health insurance before the ACA now do.

The Los Angeles Times recently reported the number of newly insured Californians is 5 million, with about 10 million receiving additional benefits, so it has helped people of every economic background. Up and down the Central Valley, the number of people who have gained coverage is in the hundreds of thousands.

Most of them work hard and now have the peace of mind that if they or their kids get sick, they will be taken care of. Less known is the fact that everywhere, in rural communities and inner cities, clinics have received money to expand coverage for basic health care. Because the ACA does not allow people who are undocumented to participate, these clinics help keep people healthier than before.

For our agricultural communities – and all of us – so dependent on farmworkers from somewhere else, this is a godsend. It seems like there isn’t a day when we don’t see a compelling story in The Bee or other news outlets about someone who is fighting a chronic disease, racking up medical bills that boggle the mind.

ACA safety net

Bankruptcy from health care costs used to be the top reason for personal bankruptcy. Under the ACA, there are no more lifetime or yearly caps on coverage and, of course, no pre-existing conditions to limit coverage. Another benefit: Children can now stay on their family’s plans until they’re 26.

And Medicare – which has transformed the lives of generations of Americans since it started in 1965 – now covers more preventive health care items that it did before. And for those seniors on Part D for their prescription coverage, the dreaded doughnut hole of non-coverage has been getting a lot smaller.

Contrary to what Sarah Palin said, there never were any death panels, but the financial viability of Medicare has been extended about 10 years.

Opponents of the ACA will point out that when the law was implemented, there were those who weren’t able to keep the same policies as before. For some that was true. It’s also true that for the first time, there are minimum standards of coverage and consumer protections that never existed before.

Like the fact that women can’t be discriminated against and forced to pay more by insurance companies for a similar policy written for a man. Some rates went up – and others went down. And, yes, before the ACA we used to see record health care cost increases back to back on a year to year basis.

A lot has been written about how we are a divided country – and we are in many ways. But most folks want a lot of the same things, whatever we call it. We want to live in good communities, where the elderly are safe and our children get a solid education and have a decent chance to be successful.

We want clean air to breathe and clean water to drink, wherever we live. And all of us have a right to affordable health care. Can this law can be made better, just as we have seen improvements to Medicare and Social Security since their inception in 1965 and 1933, respectively? Absolutely!

So often people talk about the good old days. In those good old days before Medicare, many elderly people got sick and died of illnesses that didn’t need to be fatal or debilitating. That is why life expectancy for seniors has risen over the decades since its passage. And before Social Security, a lot of elderly with no income just starved to death.

The Affordable Care Act has continued that progress of keeping more Americans healthy. I hope our leaders today will take the time to think this through before acting. It truly is a matter of life and death.

Tom Bohigian of Fresno is the retired state director for Sen. Barbara Boxer, a position he held for 12 years. He also is a former Fresno city councilman.