I found much to agree with in a Nov. 13 letter to the editor that was critical of the Affordable Care Act. There is irony in the enactment of the ACA, and there is shame in its implementation. The irony is that Obama ran on working across party lines for the good of all Americans (famously saying there are no red states or blue states but only the United States). To get Republican support, rather than proposing a one-page "Medicare For All" plan favored by progressives, the Democrats proposed market-based health reforms modeled on that designed by the Republican Heritage Foundation and signed into law by a Republican governor in Massachusetts. Many Republicans championed the now-controversial individual mandate. But, in an effort to embarrass America's first black president, Republicans walked away in lock step. Democrats barely got it enacted despite Republican obstructionism. Ironically, the ACA was originally a Republican plan, but without a Republican vote.
It is a shame that implementing the ACA has been messy, with the website getting well-deserved criticism. But the real shame is that all but seven Republican governors have refused to expand Medicaid under the ACA, leaving nearly five million Americans without affordable health coverage. Thousands will suffer and die every year without it -- including many in South Carolina. And that, my fellow citizens, is a real shame.