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affordable care act
Senate Confirms 'Profoundly Unqualified' RFK Jr. to Lead Nation's Health Agencies
"No senator should have voted to confirm Robert F. Kennedy Jr.," said one consumer advocate.
Feb 13, 2025
The U.S. Senate on Thursday voted to confirm vaccine conspiracy theorist Robert F. Kennedy, Jr. to lead the nation's health policy, a move that one advocate said puts "our entire healthcare system and countless patient lives in jeopardy."
"This is a shameful day for the U.S. Senate, an institution that likes to laud itself for its careful deliberation and seriousness of purpose," said Robert Weissman, co-president of government watchdog Public Citizen. "No senator should have voted to confirm Robert F. Kennedy Jr. Every single senator knows he's not just profoundly unqualified to head the nation's health agency but a threat to public health in the nation."
Every Democratic senator voted against Kennedy's confirmation to lead President Donald Trump's Department of Health and Human Services (HHS), while Sen. Mitch McConnell (R-Ky.) was the only Republican to oppose Kennedy. McConnell survived polio as a child and said Kennedy's "record of trafficking in dangerous conspiracy theories" about vaccines influenced his decision.
The confirmation followed Senate hearings in which Kennedy had nothing negative to say about the country's for-profit health insurance system, which has made insurers increasingly wealthy as patients' healthcare treatments are denied and delayed.
He insisted that Americans "would prefer to be on private insurance" and displayed a lack of knowledge about Medicaid and Medicare, appearing to confuse the two. He also denied being anti-vaccine while refusing to reject the debunked claim that vaccines cause autism, a failure that Sen. Bill Cassidy (R-La.), who is a physician, claimed to be troubled by—but Cassidy went ahead with his vote for Kennedy nonetheless.
"Senators who rubber stamp this dangerous nomination in fear of an angry tweet from President Trump cannot later feign concern and surprise when Kennedy's actions end up harming everyday Americans. They, too, will own the consequences."
"Any vote to confirm Kennedy to lead HHS is a vote to put our public health at risk, and senators know it," said Tony Carrk, executive director of government watchdog Accountable.US. "The war Kennedy is itching to wage against vaccines and scientific research will undoubtedly cost lives and could lead to the resurgence of diseases once thought dormant."
"Among the last people who should be overseeing our public health is Kennedy, with his non-existent health policy credentials, embrace of ludicrous conspiracies, and judgment so lacking that he potentially committed felony voter fraud despite courts warning him not to," Carrk added, referring to Accountable's accusation that Kennedy cast a ballot last year from an address that wasn't his. "Senators who rubber stamp this dangerous nomination in fear of an angry tweet from President Trump cannot later feign concern and surprise when Kennedy's actions end up harming everyday Americans. They, too, will own the consequences."
During his confirmation hearings, Kennedy angered officials in Samoa, where he spread anti-vaccine conspiracy theories just before 83 people died of measles in a 2019 outbreak. Samoa's director-general of health, Alec Ekeroma, accused Kennedy of "a total fabrication" when he told senators many of the people who died didn't have measles.
Before the Senate voted on Thursday, Ekeroma said Kennedy's confirmation to lead U.S. health agencies, which control funding for international health and vaccine initiatives as well as domestic policy, would be "a danger to us, a danger to everyone."
Weissman credited many Democratic senators for their "truly heroic efforts... to rally opposition against this dangerous nominee," and warned that "it will fall on the American people to confront his lies and policies and to defend basic public health principles and institutions."
"We should expect Robert F. Kennedy to continue spreading his conspiracies, anti-vaccine propaganda, and anti-science crusade," said Weissman. "We should expect him to deliver on his promises to sabotage our public health institutions. And we should expect him to enable and facilitate the effort to slash health care coverage for lower-income people, privatize Medicare, and undermine the subsidies and consumer protections on the Affordable Care Act exchanges."
Kennedy has claimed that he has "often disturbed the status quo by asking uncomfortable questions," but advocacy group Patients for Affordable Drugs noted that he provided little information in his confirmation hearings about how he would challenge Big Pharma by lowering drug prices and defending the Medicare negotiations introduced by former President Joe Biden.
"Secretary Kennedy has a critical opportunity—and responsibility—to build on existing measures to rein in Big Pharma's price-gouging and lower drug costs for patients," said Merith Basey, the group's executive director. "We are ready to work with him to ensure Medicare drug price negotiations continue, out-of-pocket costs are reduced, and competition in the marketplace is increased through reforms to end abusive pharmaceutical monopolies that harm patients."
"But make no mistake," added Basey. "Patients fought hard to secure the 2022 prescription drug law, and we will fiercely oppose any efforts to weaken it."
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McConnell's Stumbles in Senate Spark Call for Medicare for All
"He won't have to worry about medical bills or skipping tests because he has high-quality, government-funded healthcare—the thing he's fought to deny the rest of us," said one single-payer campaigner.
Feb 05, 2025
U.S. Sen. Mitch McConnell reportedly fell twice on Capitol Hill Wednesday, but as one healthcare advocate highlighted, the 82-year-old Kentucky Republican—who's called Medicare for All a "radical scheme" that "would be serious bad news for America's hospital industry"—won't struggle to get any needed treatment.
"Mitch McConnell fell again and is obviously not well," said Melanie D'Arrigo, executive director of the Campaign for New York Health—which fights for universal, single-payer healthcare—on social media.
"But he won't have to worry about medical bills or skipping tests because he has high-quality, government-funded healthcare—the thing he's fought to deny the rest of us," D'Arrigo added. "We need Medicare for All."
Punchbowl News' John Bresnahan and Max Cohen reported Wednesday that McConnell fell while exiting the Senate chamber, then fell again while entering a Republican lunch.
A spokesperson for the former majority leader told Bresnahan—and various other journalists—that "Sen. McConnell is fine. The lingering effects of polio in his left leg will not disrupt his regular schedule of work."
McConnell contracted polio as a toddler in 1944, according toThe Associated Press. His leg was paralyzed, but after two years of treatment, he was ultimately able to walk without a brace.
After the senator's Wednesday falls, Bresnahan said that "McConnell is using a wheelchair as a precautionary measure, we're told."
The Affordable Care Act (ACA) requires members of Congress to obtain coverage via the D.C. Health Link Small Business Market, according to the U.S. Office of Personnel Management, the federal government's human resources agency. For lawmakers with Medicare, the federal health program for American seniors serves as a "secondary payer."
The federal government covers up to three-quarters of the premium for lawmakers' primary health plans, according to a Congressional Research Service report from 2017. Another CRS report from last June points out that "in addition, the Office of the Attending Physician provides emergency medical assistance for members of Congress, justices of the Supreme Court, staff, and visitors. Additional services are offered to members who choose to enroll for an annual fee ($650.00 in 2023)."
Meanwhile, tens of millions of Americans don't have adequate health plans or lack coverage altogether. Citing the U.S. Census Bureau, the Commonwealth Fund's November 2024 report on its biennial health insurance survey notes that "an estimated 26 million Americans, or 8% of the U.S. population, lacked health insurance in 2023," and although the United States is still behind countries with universal coverage, before the ACA, 49 million, or 16% of the population, didn't have any coverage.
The U.S.-based Commonwealth Fund found that "nearly a quarter of working-age adults have insurance that leaves them underinsured," and two-thirds of those individuals had coverage through an employer plan. The survey also shows that people who were uninsured or underinsured often did not fill prescriptions, get recommended care, or visit a needed doctor or specialist.
Another survey, released Tuesday by Emory University's Rollins School of Public Health and Gallup, highlights that healthcare access and affordability is a leading priority for the American public, and a majority wants the federal government to act.
"Americans ranked improving healthcare access and affordability as the highest public health priority for government leaders to address out of 15 options," states a report from the pollsters. "One in four in the U.S. selected this issue as their highest priority and more than half (52%) rated it as their first, second, or third priority."
"Majorities of both Republicans and Republican leaners, and Democrats and Democratic leaners, chose the federal government over state government as the more effective force for addressing each of the issues that emerged as a top priority for them," adds the report—which comes as the Trump administration and billionaire Elon Musk attack the federal government.
Despite public opinion polling, President Donald Trump and the Republican majorities in Congress—who have long tried to restrict or fully roll back the ACA—aren't expected to work to expand health coverage, particularly via progressive proposals like Medicare for All, which has been championed on Capitol Hill by Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.).
Still, advocates of Medicare for All
continue to call for it. As Sanders said Monday on Musk-owned X: "The U.S. spends 2x more per capita on healthcare than any other nation. Yet 85 million are uninsured or underinsured, 68,000 die because they can't afford a doctor, and we pay the highest prices in the world for Rx drugs. Healthcare is a human right. We must pass Medicare for All."
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Trapped by Coverage: How the US Healthcare System Ties Survivors to Abuse
Universal healthcare, or at least a robust public option, would give Americans the freedom to leave jobs or relationships without fear of losing coverage.
Feb 03, 2025
Many people are nervously awaiting the fate of the Affordable Care Act, or ACA, under the new administration. If the ACA is repealed or restricted, countless women in abusive relationships could be forced to risk losing their spouse's healthcare coverage should they decide to leave.
For millions of Americans, healthcare is tied to jobs or marriages, creating dangerous dependencies. In 2023, over 60% of Americans under age 65 relied on employer-sponsored health insurance. Of these, one-quarter of women under 65 received their health insurance through a spouse’s plan.
I witnessed the devastating consequences of this firsthand during my 10 years working with a governmental agency dedicated to supporting individuals in “high-risk” domestic violence situations—cases where abuse was severe, frequent, and life-threatening. In this role, I provided crisis intervention, safety planning, and emotional support to survivors navigating unimaginable challenges. One woman I worked with called me from the doctor’s office one afternoon in tears. She had just been treated for a fractured eye socket. Her partner had thrown her against a wall the night before. While she hadn’t disclosed the cause of her injury to the medical staff, she had shared the truth with me.
Today, healthcare access is largely determined by employment and marital status, reinforcing economic inequality, gender-based harm, and rigid social roles.
Her distress, however, wasn’t about the medical care she received. It was about the idea of losing access to that very care if she ever left her partner. Ironically, the same healthcare that tended to her physical and emotional wounds was tied to her abuser’s job. Without him, she and her children would lose their health insurance entirely.
This tragic irony is the daily reality for countless individuals across the United States. For people in abusive, coercive, or manipulative relationships, healthcare tied to marriage gives abusers significant leverage. Leaving an abusive partner is never a simple decision, but the threat of losing health insurance—often for their children as well as themselves—makes it even harder. Survivors are forced to weigh their personal safety against access to life-saving care.
Employer-sponsored health insurance wasn’t always the norm. Before World War II, Americans typically paid out of pocket for medical procedures. But in the 1940s, wage controls during wartime prevented employers from raising salaries, so they began offering health insurance as a perk to attract and retain workers. Over time, this temporary solution became a default system, expanding to include dependent and spousal coverage as societal norms emphasized “family-centric” policies.
What began as a short-term fix has since created a web of unintended consequences. Today, healthcare access is largely determined by employment and marital status, reinforcing economic inequality, gender-based harm, and rigid social roles.
For survivors of domestic violence, this system compounds an already harrowing situation. The research shows that approximately 99% of domestic violence survivors experience financial abuse. Healthcare is often one of the financial tools used to exert control. Survivors may be blocked from accessing care, forced to remain in harmful relationships, or deprived of medical resources if they attempt to leave.
But the problem doesn’t end with domestic violence. The employer- and spousal-based healthcare system pressures people to conform to outdated family roles, leaving out millions who live outside traditional employment or family structures. For example, why shouldn’t someone be able to add a sibling, an elderly parent, or a close friend to their health insurance plan? Our narrow definitions of “family” exclude many from the support they need during life’s most challenging moments.
The good news is that change is possible. While we may not yet be at a point where we can fully separate healthcare from jobs and marriages, we are at a critical juncture where we can challenge the status quo and push for meaningful reform.
The Affordable Care Act was a significant step forward, but public options remain prohibitively expensive for many Americans. On average, employer-sponsored plans cost workers around $6,200 annually for family coverage, while public plans, without subsidies, can be more expensive. Closing this gap through expanded subsidies or premium caps must be a priority.
Current laws offer some protections. For example, domestic violence survivors qualify for health insurance enrollment outside standard open enrollment periods under the ACA and many private plans. But these policies are undermined by prohibitive costs and complex administrative processes, creating unnecessary barriers for those already in crisis.
Administrative barriers like these need reform. The ACA’s rollout was marred by technical issues, and today, many Americans still face confusing, inefficient systems that discourage participation. Streamlining the enrollment process and raising public awareness of available options would go a long way toward ensuring equitable access.
Long-term, we must move toward a system where healthcare access is no longer tied to employment or romantic relationships. Universal healthcare, or at least a robust public option, would give Americans the freedom to leave jobs or relationships without fear of losing coverage. No one should have to choose between their health and their safety, or between financial security and their autonomy.
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