Opinion: Many reasons why young adults should refuse to let Republicans kill the Affordable Care Act

In this op-ed, University of Wisconsin Medical School student, Samantha Crowley, shares the importance of young adults protecting the Affordable Care Act by re-electing pro-healthcare candidates this fall.

As a third-year medical student at the University of Wisconsin School of Medicine and Public Health and a future emergency medicine physician, I was honored to have the opportunity to join Wisconsin Sen. Tammy Baldwin and other health care advocates last month for an event celebrating the 14th anniversary of the Affordable Care Act (ACA) being signed into law by then-President Barack Obama. 

While I am too young to remember what it was like to take care of patients prior to the ACA, I can still remember stories of the devastating impacts when young people like myself were unable to seek medical care because they didn’t have insurance. When I was in elementary school, there was a 20-year-old girl from a few towns over from mine who fell off of a boat in her college town. She didn’t have insurance, so she decided not to go to the emergency room to seek care. Over the next few days, her leg became increasingly red, swollen, and hot. As a medical student, we’re taught to automatically think about a blood clot when we hear these words. She still didn’t think she could afford a trip to the emergency room, so she made an appointment with her primary care doctor for the following Monday. Over the weekend, part of the blood clot broke off and went to her lungs. This young woman died of a pulmonary embolism, a very treatable condition if caught in time, because she was afraid of how much an ER visit would cost her. The Affordable Care Act could have saved her life, and is continuing to save the lives of so many young people since it was implemented nearly a decade and a half ago. 

I think it is sometimes easy for us to forget what the health care system was like before the ACA, as many of us grew up benefitting from the Affordable Care Act itself. Do any of you have any health problems like asthma or diabetes? Those are pre-existing conditions that in the old days health insurance companies could refuse to cover because you were going to cost them money. This discrimination is all because health insurance companies only wanted to cover healthy people in order to maximize their profits. If it isn’t covering us for our health problems exactly what health insurance is for? 

That consumer protection of pre-existing conditions alone has fundamentally changed the landscape of health care in America thanks to the ACA. During the Trump presidency, Republicans in the House of Representatives managed to pass a repeal vote on the ACA. Thankfully, the Senate blocked the repeal with a single thumbs-down vote from the late Arizona Republican Sen. John McCain. But between those votes President Trump threw a pep rally on the White House lawn celebrating the ACA repeal he thought was assured. 

Now, running again for the highest office in the land, Trump is back to promising to “terminate” the Affordable Care Act. This wasn’t a slip of the tongue, he has repeated it at least seven times. 

There are a lot of huge issues before us this year. One that ought to be front and center for every young American are the stakes for American health care. President Joe Biden has made strengthening the ACA a major priority of his administration. He has worked to make it easier to enroll in Obamacare marketplace plans, fixed the “family glitch,” and passed the Inflation Reduction Act (IRA). 

Many are aware the IRA was the largest single effort to address climate change in world history. It also is the single largest reform of the health care system since passage of the Affordable Care Act—making huge strides in the fight to lower prescription drug costs and make health insurance more affordable. Today, the ACA is more popular than ever with a record 21.4 million people signing up for 2024 Marketplace coverage, including more than a quarter-million Wisconsinites. 

That progress matters. For many of us pursuing higher education. For many of our families. For many of our neighbors. Progress does not suggest perfection, to be sure. But the commitment to furthering that progress demonstrated by President Biden and Democrats in Congress clarifies what’s at stake this year. 

Throughout his term, with a Republican-controlled Congress, Trump worked to dismantle the ACA without ever putting forth a plan for what would replace it. Trump also used executive action to weaken and undermine the ACA where he could—making it harder to enroll in the marketplace, for example. 

This is not just a Trump problem either. Republicans, including their likely US Senate candidate here in Wisconsin, have long supported ACA repeal, which has faced more than 70 attempts to repeal it in Congress. 

Facts are facts. Past history is the greatest indicator of future performance. And by those measures, the ACA is at risk if Trump and Republicans get an opportunity to repeal it. President Biden, Vice President Kamala Harris, and Democrats in Congress have not only defended against those repeal attempts for nearly 15 years, they are working to build on the progress made by the landmark law. 

On health care, the stakes are clear, as is the choice. We must re-elect our pro-healthcare candidates this fall.

Related: Trump vows again to try to ‘terminate’ Affordable Care Act, while Wisconsin Dems push to make it better