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Rank-and-file nurses and healthcare advocates will resist attempts by the Trump administration to repeal the Affordable Care Act – unless it’s replaced with Medicare for All, says Donna Smith of Progressive Democrats of America

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KIM BROWN, TRNN: Welcome to the Real News Network in Baltimore. I’m Kim Brown. Pretty much since it was passed into law in 2010, the republicans in congress have vowed to repeal and replace the Affordable Care Act otherwise known as Obamacare. On at least 60 occasions, the house, they voted to do just that. But it was all for naught because there was no way that President Obama would repeal his signature legislative piece. But now with the election of Donald Trump to the White House, Obamacare may soon be on the way out. Joining us to discuss this is Donna Smith. Donna is the executive director of the Progressive Democrats of America. She was also formerly a legislative advocate for the California Nurses Association and she’s joining us today from Oakland. Is that right Donna? DONNA SMITH: Actually I’m in Denver today but thank you Kim for having me on. BROWN: No problem. So Donna, in a little bit of breaking news here, the Wall Street Journal is reporting that President-elect Trump said in a recent interview that he would consider leaving two parts of the Affordable Care Act in place. Once Being not allowing the insurance companies to deny coverage because of pre-existing conditions and how young adults can remain on their parents insurance until age 26. What are your thoughts about this revelation from President-elect? SMITH: Well thank you Kim first of all and thank you for having me on the Real News Network again. It’s been an unbelievable week in terms of how many of us have flet about what’s likely to be coming in the future for healthcare, hearing this latest news today from the Wall Street Journal and from President-elect Trump. I can’t even believe I’m saying that- is actually kind of a ruse in terms of what Americans need for healthcare and allowing for protection from pre-existing conditions. Insurance companies aren’t going to like that if they don’t have everyone mandated to buy their insurance. And the issue of keeping young people on their parents insurance policies until they’re 26, I agree that’s important. But if that’s the only thing they’re going to keep form the Affordable Care Act over time, clearly we need to move to a different plan ad for many of us, we know that the only sensible alternative is to move to a Medicare for all time system. Now whether or not Donald Trump can be true to what he once believed very early in his career that that that was the only viable economic and human system to have, it remains to be seen. I rather doubt it at this point. But that does not mean that the American people don’t see the need for something different. BROWN: Well Speaker of the House and Wisconsin congressman Paul Ryan along with many other republicans have long said that Obamacare is a bad deal for Americans and recently appointed to the sharp rise in premiums that are coming soon. So as you said, a Medicare for all system, I mean is that the better way of covering the uninsured besides what we have now? SMITH: Well of course it’s the better way of covering all of us than what we have now. But Paul Ryan is a really dangerous sort of guy in terms of what he sort of thinks about the social safety net of healthcare and social security in this country as it is. Always under the guise of efficiency. Always under the guise of smaller government. Yet what actually happens, let’s look for real. If they were able to repeal all of the portions of the Affordable Care Act or significant portions we end up with at least 20 million people losing their health coverage. Maybe as many as 50 million people again uninsured. I mean that’s going backwards in a really, really significant way. The United States has tried just about everything. Aside from doing what the rest of the world has known for a very long time, that some manner of Medicare for all, some way to bring a single payer system to life, is the only way to really get everybody covered to have some kind of control on costs and to be decent with your own economy with it. The United States currently, you know we’re approaching 10 thousand dollars per capita spending on healthcare. That’s even with many people not accessing much healthcare at all. You just go very very shortly to the north and you find that Canada costs that are nearly half of what that cost is. You can go to almost any country in Europe and spend a lot less. So it just doesn’t ring true that they’re concerned about smaller government and less spending when they avoid this. It really becomes more of an argument about what kind of people are we and I’m hoping that what we’re finding out is not that the kind of people we are is very selfish and very willing to let people around us suffer and die. BROWN: There’s been a handful of pieces circulating this week. One in the Daily Beast, another in New York Magazine, encouraging women who are child-bearing age to seek IUDs or women who are pregnant or planning to be pregnant to seek prescriptions from their doctors to get breast pumps because as of right now, these items are still covered under the Affordable Care Act, under Obamacare. Are there particular implications for women who don’t have employer provided health insurance if Obamacare goes away? SMITH: Well of course, I mean the reality is the Affordable Care Act did provide healthcare for a huge number of women and women of child bearing age. Not only through the provisions of providing preventative care but just by manner of getting so many more women coverage in general. Coverage through Medicaid expansions in 31 states. Coverage through more private insurance sold on the exchanges. What was required of insurance companies to make sure that that coverage meant certain minimum standards. I mean how sad is it to hear about women who are having to take preemptive activities to try to make sure that if something happens on day one or week one as Donald Trump is now trying to reassure everyone that he will act rapidly to move forward on his policy agenda, what kind of a terrible message is this to girls and women about whether or not they’re valued in this society or not. I don’t see any similar move to remove any issues related to men and their reproductive health and the kinds of things they may need. I certainly don’t see any of that kind of energy and it’s really very upsetting and frustrating. I also saw a report today that talked about the fact that one of the things that Trump administration may consider doing is stopping any appeals of employer based insurance being required to cover birth control services for women. While that wouldn’t be an overt action to end that, to just stop the appeals of that at the court is really another hit at women. Just one more swing at women from a party that has tried to reassure people that women’s lives and their health is as valuable as anyone else’s. The actions coming out of this President-elect and his transition team, they’re right. They’re moving rapidly and they’re moving exactly on the agenda that they’ve explained to the American people which did include a lesser view of women, a lesser view of what it means to protect our health, a lesser view of what we’re able to do to be fully productive and fully take care of our own bodies according to our needs and the needs and the wishes and the medical advice of our providers instead of being told by our government what we’re supposed to do with our bodies. That really flies in the face of this whole notion that Paul Ryan and Donald Trump and other put out there about we don’t want the government in our healthcare. Really? Well apparently you want the government in women’s healthcare. That apparently is okay with you because there are no restrictions that I’m aware of on any male health issue. Whether it’s related to reproductive rights or not. This is just, it’s horrible. It’s horrible stuff. BROWN: Let’s talk about this election of Mike Pence, now the Vice President-elect. Now who’s been named the chief of Donald Trump’s transition team. Mike Pence is the governor of Indiana. Mike Pence has enacted some very disturbing things in Indiana, including closing down or restricting the funding to planned parenthood that had some dire health consequences in areas of Indiana where there was a subsequent HIV outbreak. There’s been a number of problems relating to these very conservative and extreme actions that Mike Pence has taken. What can we expect from now Vice President-elect Mike Pence, now that he has his fingertips on policy that can effect women nationwide? SMITH: What a good question. And so many people have been worried about that. You know the vitriolic speech of Donald Trump and his terrible stance on women and his terrible behavior towards women in the past. But Mike Pence is no slouch on that particular score either. In fact, I’ve heard many women claim that Mike Pence in some ways is more dangerous than president-elect Trump in terms of his treatment of women, his interference with women’s health issues. It always trikes me that men like Mike Pence and Donald Trump think that they have the right and then when they are elected, they think that they somehow have the responsibility to speak for and about women ‘s health and you’re right. Pence in Indiana has done disastrous things for women’s reproductive freedom, for Planned Parenthood. Planned Parenthood, the clinics that have provided not only birth control services and family planning services. But a lot of women’s health services all over the nation have been provide for many years by Planned Parenthood. And shame on him and shame on the Republicans for thinking that that’s the way they push through an agenda that really relates more to their religious beliefs than it does to the belief in all people being equal in this country. The reality is their religious beliefs, their entitled to them. They do not have to participate in Planned Parenthood. The females in their family can make a choice or not to go to Planned Parenthood for services or to have an abortion, or to use birth control or any of the other things that women may choose to do with their reproductive health or any other part of their bodies. But the reality is my religion, my faith weather I have a faith or a lack of faith or whatever my position may be, my body is my body. I have the right to determine what happens with my body and where I go for care. We are likely to say Mike Pence who tries to be a very very active participant in making sure we restrict more women’s rights, again this is saying some really bad things to women about how they are valued, how they are viewed and how men in this new government will control us. BROWN: Donna you have worked previously advocating on behalf of nurses in California. Have you been speaking with healthcare workers at all about what a president-elect Trump could mean, not only for the Affordable Care Act but as you mentioned earlier there have been at least 20 million people who have been covered under Obamacare. What are healthcare workers saying about the implications if this piece of legislation goes away? SMITH: Well I think there’s great uncertainty. I mean first of all, as much as they’d like to puff and brag about how they’re going to make it go away on day 1, this is a pretty complex piece of legislation that will take some time to dismantle. Having said that, dismantling it is a wrong way to go unless what we’re talking about and this is certainly what many nurses I know and healthcare workers and professionals will be fighting for unless taking away the Affordable Care Act means replacement with Medicare for all. A system that Americans understand. A system that a majority of Americans support. A system that brings greater economy to the system that starts to get control over almost 18% of our gross domestic product spent on the healthcare industry. So while there’s great uncertainty among healthcare populations I think the greater uncertainty I hear right now is among rank and file Americans who are very concerned especially those who get their coverage from the exchanges. About not only the rising rates of premiums which indeed is a big problem under the Affordable Care Act. No one denies that. Those are premium increases are not sustainable. But the way we fix that is not to go back to a largely free market system that also was not very good at making sure we got people covered. Was terrible at really allowing people the kind of healthcare access they need. I even heard Donald Trump say early in this campaign that he thought even republicans would be adverse to seeing people suffering in the streets without healthcare. That there would be a way and mechanism. So there will be a strong push by not only nurses from National Nurses United, from the California Nurses Association, from the Minnesota Nurses, the Massachusetts Nurses, the nurses all over the country will be fighting for this. But so too will advocates from healthcare now and progressive democrats. The people summit groups that came together. The folks who worked on Bernie Sanders campaign and so many people who knew and put forward the only plan that really can fix this that is really supported by the majority of Americans which is Medicare for all. Once they start talking about moving in that direction, then we can have some meaningful talks about repealing and replacing the Affordable Care Act, Obamacare. If they’d like to talk about that particular option, I think they might be able to get the American people to agree with them on that. But so long as they’re talking about moving backwards I think that is a ridiculous plan. It dooms them to failure on their health plan and the failure will no longer lay at the feet of Obama. It will lay at the feet of Donald Trump, at the feet of Mike Pence, at the feet of Paul Ryan, at Mitch McConnell’s feet and that’s where it will lay along with the bodies of millions and millions of Americans who will have died and suffered because they refuse to act in the way the rest of the world has proved is the right way to go. BROWN: Alright we’re going to leave it there. We’ve been speaking with Donna Smith. She’s the executive director of the Progressive Democrats of America. Also formerly a legislative advocate for the California Nurses Association. Donna we appreciate you today, thank you. SMITH: Thank you. BROWN: And thank you for watching the Real News Network.


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Donna Smith is a community organizer and legislative advocate for the California Nurses Association.