Efforts to Dismantle the Affordable Care Act (Obamacare)


Dr. Richard Allen WilliamsBy:

Richard Allen Williams, MD

117th President, National Medical Association

Clinical Professor of Medicine, UCLA School of Medicine


As the President of the National Medical Association, the world’s oldest and largest organization of black physicians, and as the author of several books on healthcare disparities, healthcare reform, and equity and diversity in medicine, I have been able to view the current attempts being made by the Trump Administration and the U.S. Congress to dismantle the Affordable Care Act (the ACA or Obamacare) and to replace it with the Better Care Reconciliation Act (the BCRA or Trumpcare) from a special perspective. I think it is very important to recognize that the outcome or fallout from such a transition, which most pundits advise would result in disaster for at least 22 million people by virtue of removing their health insurance coverage, will have a racially and ethnically biased impact that has not been fully appreciated: African Americans and other people of color will suffer disproportionally mainly because they are the most impoverished and resource-deficient citizens in the nation. Simply put, the axe-wielding purveyors of destruction who are set upon devastating our healthcare system under the pretense of improving it are not equal opportunity destroyers. Those who will be hurt the most are those who are the most vulnerable, and blacks are vastly over-represented in this group.

Let’s look at the facts. Starting with the passage of the ACA, the numbers of uninsured people began to fall drastically, to the point where in 2016, six years after it was enacted, the percentage of those without coverage had been cut in half. It is no coincidence that health metrics for the entire population showed a dramatic improvement, especially for chronic diseases which form the bulk of the healthcare burden, consisting of almost three-fourths of the total. Very importantly, African Americans and other people of color benefited the most; for instance, the death rate for blacks decreased 25% compared to 17% for whites, according to a recent report from the Centers for Disease Control and Prevention (the CDC) entitled Vital Signs. So the ACA has been good for the health and survival of blacks as indicated by a decrease in healthcare disparities. The reason? According to Dr. J. Nadine Gracia, the former Director of the Office of Minority Health in the Department of Health and Human Services during the Obama Administration, as quoted recently in the Atlantic, “ The Affordable Care Act is the most important law to help reduce health disparities since the passage of Medicare and Medicaid…because the law is addressing issues of access, affordability, and quality of care, which have all been obstacles and barriers that relate to the health of minorities.” It has been documented that tens of thousands of lives have actually been saved under the ACA, and, as mentioned, blacks have been among the main beneficiaries.

Enter the Better Care and Reconciliation Act, which is currently going through desperate attempts to modify it into something that is acceptable to Republican senators.  Its primary destructive instrument is the eradication of Medicaid expansion by removing $800 billion dollars of its Federal funding. This cruel act alone will spell doom for millions of poor people, casting them into the creek without a paddle, as the saying goes, and jeopardizing their lives and health. Since a higher percentage of impoverished citizens who qualify for Medicaid are black, with 94% of blacks meeting the criteria of being under 138% of the Federal Poverty Level (FPL), it is obvious that they are at greater risk of suffering from the potential loss of Medicaid.

In conclusion, although the loss of Obamacare and the imposition of Trumpcare is an ominous prospect for everyone in this nation, African Americans stand to lose more than any other population group. As the organization charged with protecting the health and wellness of black people, the National Medical Association declares war on the Trump Administration’s plans to achieve passage of the so-called Better Care Reconciliation Act. We call on the American people to join us in our efforts to derail this deadly plan and to contact the senators in your state to convince them to oppose this bill and to vote NO if it is submitted for a vote. This is truly a matter of life or death, and your actions can make a huge difference.

Click here for the link to Dr. Williams’ related slides:


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