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Monday, December 09, 2019 {{ new Date().getDay() }}

My friend Isatou has just received an invoice from Kaiser Permanente, testament to her new coverage through the Affordable Care Act — usually called “Obamacare.” She’s thrilled to finally have health insurance so she can get regular checkups, including dental care.

A reasonably healthy middle-aged woman, she knows she needs routine mammograms and screenings for maladies such as hypertension. But before Obamacare, she struggled to pay for those things. She once had to resort to the emergency room, which left her with a bill for nearly $20,000. (She settled the bill for far less, but it still left her deeply in debt.)

She is one of more than 7 million people who have signed up for health insurance through the ACA, stark evidence of the overwhelming market demand. Despite a badly bungled initial rollout, a multimillion-dollar conservative media campaign designed to discourage sign-ups, and a years-long Republican crusade against it (50 votes to change the law), millions got health insurance.

That hardly means Obamacare is a raging success. It’s much too early to know how it will affect health outcomes for the previously uninsured. But it’s abundantly clear that the ACA has already made great strides in improving access to health care. And that alone is quite an accomplishment.

Now, young adults can stay on their parents’ health insurance policies until they are 26 years old — a boon in an economy where many young folks are struggling to find decent jobs. Now, patients with previously diagnosed illnesses (“pre-existing conditions,” in insurance lingo) can’t be denied coverage. Now, the chronically ill don’t have to worry about hitting a lifetime cap that would deny them essential procedures or pharmaceuticals. Now, working folks who don’t get insurance through their employers can purchase affordable policies.

Factoring in the Medicaid expansion, the ACA has extended health care coverage to an additional 9.5 million people, according to the Los Angeles Times, which gathered data from national surveys. Needless to say, millions more would have been covered if so many Republican governors, mostly located in Southern states, had not callously refused to accept the Medicaid expansion despite the fact that it is largely paid through federal government funds.

The GOP’s relentless opposition has been puzzling. Republicans have resorted to extreme measures to try to derail Obamacare, including an implicit threat to prevent the National Football League from participating in a marketing campaign to encourage people to sign up.

Oh, did I mention 50 votes to repeal or alter the law?

Even acknowledging that our politics have become bitterly polarized, I don’t understand this one. Even taking into account the GOP’s irrational hatred for President Obama, I don’t get it. Even though I know that Republicans believe in less government, I don’t understand their approach to Obamacare.

First off, the ACA adheres to market-based ideas, many of which were first suggested by conservatives. Instead of a single-payer system like, say, Medicare, the ACA relies on private insurance companies. It adopts the individual mandate that was supported by many Republicans, including Newt Gingrich, back in the 1990s and later adopted by Mitt Romney in Massachusetts.

Second, Republicans are free to offer up a health care scheme that is more in keeping with conservative principles. But the “repeal and replace” mantra is rarely heard anymore since it has become increasingly clear that the GOP has no intention of coming up with a plan to replace Obamacare. While there are various counter-proposals floating about, none has garnered the support of a majority of Republicans in Congress.

Is the ACA perfect? Absolutely not. There is much in the law that needs to be worked on, refined, improved. But the GOP doesn’t seem interested in that. Instead, its members have taken to engaging in increasingly ridiculous criticisms, including the charge that the White House has made up the number of successful enrollees.

It’s strange. Could it be that Republicans are simply furious that millions of Americans like Isatou finally have health insurance?

(Cynthia Tucker, winner of the 2007 Pulitzer Prize for commentary, is a visiting professor at the University of Georgia. She can be reached at cynthia@cynthiatucker.com.)

Photo: Fibonacci Blue via Flickr

A Week That Was Disastrous For Trump, Miraculous For Biden

Donald Trump paid just $750 in federal income taxes the year he was elected president, according to a blockbuster report published by the New York Times on Sunday.

The Times report also found that Trump is millions of dollars in debt, incurred through a series of failed business ventures — a fact that runs counter to Trump's self-made image as a successful businessman. Trump has also used his financial failings to avoid paying taxes, the report found.

The president has resisted revealing his financial information since the start of his first presidential campaign, despite promising otherwise. "I would certainly show tax returns if it was necessary," Trump told conservative radio host Hugh Hewitt in 2015. Yet for five years, the president has failed to produce the documents.The president paid $750 in federal income taxes in 2016, and paid another $750 in 2017, according to the report. And in 2014, Trump paid zero dollars in taxes.

Conservatives including Trump often suggest that undocumented immigrants take advantages of government services without contributing their fair share. Throughout his first term, Trump has repeatedly cast blame on immigrants and suggested they post an economic burden to U.S. taxpayers.

"Our current immigration system costs America's taxpayers many billions of dollars a year," Trump claimed in 2017 during his first presidential address to Congress.

That claim does not hold up to scrutiny. In reality, undocumented immigrants pay billions of dollars in taxes every year. In 1996, the Internal Revenue Service created a program for non-citizens who work in the U.S. to report their income. Non-citizens who do not have a Social Security Number — including undocumented immigrants — are able to file taxes using an Individual Taxpayer Identification Number, or ITIN. According to the IRS, 4.4 million people paid taxes using an ITIN in 2015, totaling $23.6 billion in tax revenue.

This raises the question: why would undocumented immigrants pay U.S. taxes if they are unauthorized to live in the country? Immigrants often choose to pay taxes in order to demonstrate "good moral character" when applying for legal residence or citizenship, according to the National Immigration Law Center. Undocumented immigrants who fail to pay their taxes risk deportation.

"Immigrants, both documented and undocumented, paid an estimated $328 billion in state, federal, and local taxes in 2014 alone," Stephen Yale-Loehr, a professor of immigration law practice at Cornell Law School, told the American Independent Foundation. "It is outrageous that the average undocumented immigrant in the United States pays more in federal income taxes than the President did in 2016."

This contrast is especially ironic given Trump's tendency to deride unauthorized immigrants as irresponsible lawbreakers. Trump has a tendency to respond to criticism with projection — when accused, he accuses others of the same thing.

"Yes, undocumented immigrants are helping fund the very system that detain and deport us," journalist Jose Antonio Vargas, who is undocumented, tweeted in 2019.

Published with permission of The American Independent Foundation.