A word on Obamacare. I relied on it until just recently when I joined New York’s staff and went on an employer’s plan, and, to tell the truth, part of me didn’t even want to make the change — even though it will obviously save me a lot of money. What Obamacare did for me, living with the preexisting condition of HIV, was, first of all, give me far more independence and freedom. It gave me the confidence to quit a previous job and start my own little media company — my blog, the Dish. It gave me peace of mind when I subsequently shut that business down and was able to stay on the same plan. It allowed me to be a freelance writer without fear of personal bankruptcy. I got no subsidy, but I was glad to pay the premiums for me and my husband because it gave me a sense of control over our finances and our future. I knew I wouldn’t suddenly find myself facing soaring health-care costs or no health care at all — and the premium actually went down a smidgen last year.
You might think Obamacare would violate my generally conservative principles, but it didn’t. In fact, it seemed to me to be an effective marriage of conservative principles and, well, human decency. The decency part comes from not blaming or punishing the sick for their condition. The conservative part comes from the incremental nature of the reform, and its reliance on the private sector to provide a public good. For good measure, it actually saved the government money, and it slowed soaring health-care costs. The exchanges, with predictable early hiccups, largely worked — a case study in the benefits of market competition. The law allowed for experiments to test how efficient health care could be. It even insisted on personal responsibility by mandating individual coverage. And the concept of insurance is not socialism; it’s a matter simply of pooling risk as widely as possible. If any European conservative party were to propose such a system, it would be pilloried as a far-right plot. And yet the Republican Party opposed it with a passion that became very hard for me to disentangle from hatred of Obama himself.
The Trump GOP’s attempt to abolish it is therefore, to my mind, neither conservative nor decent. It’s reactionary and callous. Its effective abandonment of 95 percent of us with preexisting conditions will strike real terror in a lot of people’s hearts. Its gutting of Medicaid will force millions of the poor to lose health care almost altogether. It will bankrupt the struggling members of the working and middle classes who find themselves in a serious health crisis. It could hurt Republicans in the midterms —though that will be cold comfort for the countless forced into penury or sickness because of Trump’s desire for a “win.” But it’s clarifying for me. It forces me to back a Democratic Party I don’t particularly care for. And it destroys any notion I might have had that American conservatism gives a damn about the vulnerable. It really is a deal-breaker for me. I hope many others feel exactly the same way.