Barack Obama spoke Thursday to an audience at the United Community Center on the south side of Milwaukee, Wisconsin. The president came to congratulate Milwaukee on beating out 19 other cities by signing up the greatest proportion of its residents for the Affordable Care Act (ACA) for coverage in 2016.
With the Healthy Communities Challenge, the White House targeted 20 of the nation’s poorest cities—including Detroit, Philadelphia, Chicago and Milwaukee—to sign up people for health insurance under the program commonly known as Obamacare. Milwaukee’s prize for winning was a visit by the president.
Obama’s remarks were notable for both their cynicism in painting the ACA as a great boon to the health and wellbeing of residents in Milwaukee and other communities across the U.S., as well as for what he purposefully omitted to say. Listening in, one would never have suspected that he was speaking in America’s fifth most impoverished big city, which has been devastated by deindustrialization, unemployment and low wages.
Milwaukee won the competition by signing up about 89,000 people in the area for both new and renewed Obamacare coverage for 2016. “Health care is not a privilege for the few, but should be a right for all people,” the president said. He told his audience, “You’re proof that the Affordable Care Act works.”
But the president’s argument that signups for Obamacare prove that the law champions health care as a “right for all people” is undermined by an examination of ACA plans both in Wisconsin and across the country. What quality of medical services are people receiving and what are they paying for it? And how is the ACA contributing to alleviating the conditions of poverty and suffering, which have led to declining lifespans across the U.S. in broad demographic categories?
Milwaukee had a poverty rate of 29 percent in 2014, according to the U.S. Census. The poverty rate among African-Americans was 39.9 percent, and 31.8 percent among Hispanics. More than 42 percent of the city’s children live below the poverty line, defined as $24,008 for a family of four in 2014.
The ACA’s individual mandate requires people without health insurance from either their employer or a government program such as Medicare or Medicaid to purchase insurance from private insurance companies at the exchanges set up under the legislation, or pay a tax penalty. Under the ACA, low-income individuals and families receive modest subsidies to go toward the premiums.
It is likely that some of those uninsured Milwaukeeans who have yet to sign up for ACA coverage are exempt from the fines—and remain uninsured—because they qualify for an “economic hardship” exemption due to poverty.
Obama touted the affordability of the plans on offer in Wisconsin, saying, “Most folks shopping have found that they can buy a plan for less than $75 a month.” And a quick search on Wisconsin’s ACA exchange did indeed find that a family of four with a household income of $30,000 living in the vicinity of the United Community Center would receive subsidies that covered all or most of monthly premiums for the least expensive bronze plans.
The president did not, however, refer to the reality facing many families who are buying coverage: staggering deductibles. In the plan cited above for a family on Milwaukee’s south side, the deductible—the amount that must be paid out of pocket before all but certain “essential” medical tests and services are covered—was $10,000!
A study by Freedom Partners, which opposes Obamacare from the right as akin to “socialized medicine,” found that deductibles for ACA plans have risen in 41 states this year, with 17 of those states experiencing deductible increases in the double digits. For Wisconsin as a whole, bronze plan deductibles rose an average of $482, with deductibles across all plans rising by an average of $477.
The truth behind these figures is that low-income families “insured” through these high-deductible plans will more likely than not be forced to self-ration, forgoing needed medical services because they cannot afford to pay for them out of pocket before coverage kicks in.
While Obama did not mention this inconvenient reality, he did insist that “The Affordable Care Act, aka Obamacare, is saving lives and it’s saving money.” In an admission that the aim of the legislation is to cut costs, he said that the ACA is “forcing hospitals to work on quality of care” as opposed to quantity. He repeated the spurious claim that better health care could be achieved through government, corporations and health care providers spending less.
Obama also attempted to directly link what he described as a “steady economic recovery” in the U.S. since the Great Recession to Obamacare. He claimed that “14 million new jobs” had been created since the ACA was signed into law six years ago this month.
Such statements are cold comfort to residents of Milwaukee, who as part of America’s Rust Belt—including Detroit; Cleveland, Ohio; Buffalo, New York and other cities—have been ravaged by decades of deindustrialization. Manufacturing jobs in the city—once home to the Pabst Blue Ribbon brewery, the American Motors Company, and the Allis Chalmers agricultural equipment manufacturer—have declined by more than 75 percent from their peak in the 1960s.
Similar to Obama’s recent visit to the Detroit auto show—in which he praised the alleged “comeback” of Michigan and its auto industry in the midst of the Flint water crisis, the contract struggle in auto and the crumbling of Detroit’s schools and infrastructure—the president’s visit to Milwaukee was a cynical maneuver aimed at shoring up his support among the ruling elite as a defender of big business and the banks.
In his last year in office, Obama particularly seeks to defend the “legacy” of his signature domestic program, the ACA, the aim of which is to cut costs for private insurers, corporations and the government, while rationing health care for the vast majority of Americans.
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