Jason Stevenson: How the ACA won the war over health care in Utah

Obamacare is here to stay and not even Utah Republicans are willing to vote against it.

(U.S. Centers for Medicare & Medicaid Service via AP) This image provided by U.S. Centers for Medicare & Medicaid Service shows the website for HealthCare.gov.

Ahead of the 2018 midterm elections, polls ranked health care as the top issue for voters. Fast forward to 2022, and health care doesn’t crack the first five topics on voter’s minds. While new challenges like the pandemic and inflation have emerged, this shift also means one thing more: The Affordable Care Act (ACA) is here to stay.

Five years ago, the debate over President Barack Obama’s landmark health care reform was front, center, and very loud. Remember Sen. John McCain’s thumbs-down vote that saved the ACA from being repealed? Or the multiple Supreme Court decisions that rescued the law from hostile lawsuits.

Recall the raucous town-halls in 2017 where Republican lawmakers faced constituents enraged by their attempts to gut the ACA’s pre-existing condition protections. As a result, Congress hasn’t tried to harm the health care law since 2017, and no one today is talking about repeal. In contrast, lawmakers extended Medicaid eligibility in 2020 and boosted the ACA’s premium subsidies until 2025. Even the lawsuits filed by Republican-led states to hamstring the ACA are fading away.

The ACA is gaining acceptance in Utah, too. When Burgess Owens campaigned for Congress in 2020, he edited his website to remove a pledge to repeal the ACA, replacing it with “Obamacare no longer needs to be repealed, but changes are necessary in the current healthcare plan.” Even the hyper-conservative Owens knew that attacking the ACA wasn’t a winning strategy in Utah.

These days, Rep. Chris Stewart, who once held numerous forums attacking the ACA with dubious facts, doesn’t even have a tab for “health care” on his website. Nor does Sen. Mike Lee, an ardent foe of the health care law in the past.

But you don’t need to listen to politicians to realize the ACA is more secure today. Just follow the people. Utahns are signing up for the ACA’s game-changing health insurance in droves. In 2022, 256,932 Utahns are enrolled in an ACA insurance plan, or about 1 in 12 residents. Since 2014, enrollment in Utah has grown an average of 15% each year.

Compared to states with similar populations, such as Iowa, Connecticut and Nevada, Utah has two to three times more people reliant on ACA coverage. No wonder Utah’s Republican politicians have stopped bashing Obamacare: Too many of their constituents depend on it.

I knew the ACA was going to succeed in Utah back in 2015 when I traveled the state giving presentations about the new health insurance marketplaces. At the time, I worked for the Utah Health Policy Project, a nonprofit that still provides free assistance for Utahns enrolling in coverage.

Using realistic profiles of what families would pay in premiums and co-pays, as well as explaining new benefits like free preventative care and vaccinations, I conducted more than 240 seminars to reach 10,000 Utahns with accurate facts about the ACA. Along the way I learned how Utahns were hungry for new and better health insurance options for their families. They wanted coverage without the pitfalls and fine print that made people suspicious of insurance in the past.

When people told me they got a good deal under the pre-ACA health insurance system, I congratulated them on their luck. Their low premiums were only possible because insurers could legally exclude millions of people with pre-existing conditions, charge women more than men, require long waiting periods and restrict medications for diabetics and cancer patients. Heart-wrenching stories from others in the audience proved it only took one bad diagnosis, one layoff or one premature baby for the old health insurance system to kick people to the curb faster than they could say “GoFundMe.”

Even if Republicans win back Congress and the presidency by 2024, they are unlikely to try to repeal the ACA. By then, 10 years after the launch of the ACA marketplaces, a health insurance system that promotes the well-being of families over the bottom-lines of insurers will be cemented in our society.

Lawmakers can vote against health care access at their own risk, because, like the safety nets of Social Security and Medicare, or government investments like national parks, the Eisenhower interstate highways, or the GI Bill, the ACA is here to stay.

Jason Stevenson

Jason Stevenson is a writer and resident of Salt Lake City. The views and opinions expressed in this article are solely his own.