Thread by @ASlavitt

If you care about health care in America, the Build Back Better program that Congress will vote on, may be as impactful as the ACA or more.

Here’s why.

First, millions more Americans who are uninsured will finally have insurance. Medicaid would finally be expanded to every state in the nation.

4 million ppl in states like Georgia, Florida, Texas & North Carolina will see this highly popular program expand. 2/

The health outcomes— in reducing maternal & child mortality, reducing cancer & cardiac disparities, and lifting people out of poverty— is overwhelming from Medicaid expansion. 3/

ACA exchange premiums are also about to be significantly reduced— which also means deductibles will go down.

The ACA provided insurance to millions but middle class Americans were paying too much. The $160 billion in the bill would go a long way to fixing this. 4/

Seniors would receive long overdue hearing coverage through Medicare. Somehow for seniors, the two flappy things on the side of our head were not considered part of their body.

Talk to seniors isolated because they can’t afford hearing aids & you will celebrate this.5/

Those pieces I just described are frankly great, but not the biggest part of this thing. In large part, the root cause issues this bill tackles for families & their pocketbooks are an even bigger deal. 6/

First let me lay out what’s being done:
-universal pre-school for 3 & 4 year olds
-extending child tax credits
-a million affordable housing units
-a massive commitment in at home care for seniors & disabled Americans
-a down payment on moving the country to renewable energy 7/

Some may ask what these investments have to do with health care.

The answer: everything. 8/

Oddly, we can’t fix health care by fixing health care.

Our health is affected at least 50% according to most studies by factors like our income, trauma, our ability to afford healthy food & a place to live, and increasingly by the environment. 9/

There’s little the health care system can do for people when they can’t afford to show up until it’s an emergency.

Other wealthy countries invest twice what we do in social services. And that’s one reason their health care costs are about 1/2 of ours. 10/

These are massively exciting investments— as are the potential investments in at home care.

Disabled Americans & older people are too often forced into nursing homes because there aren’t the resources to care for them at home. This is a crime. 11/

By paying health care aides more and establishing better home & community based services, we are making good on a promise that is long overdue.

This pandemic has taught us the dangers of nursing homes & congregate settings. 12/

Living at home— whether through life if you need an aide— or in our later years— has been a promise for so many years that we’ve never realized.

This bill would bring us closer to this promise. 13/

Taken together, this bill— on a health care basis alone— would join the ranks of Medicare & Medicaid in 1965, Children’s Health Insurance in 1997 & the ACA in 2009– as impacting the most Americans.

This time— not in just the usual ways— but in some more transformative ways. 14/

There will always be more we need to do to make health care better for people— even after passing this bill.

The crime of it & it’s limitation & our country’s limitation is borne out in a single fact. It will pass without a single Republican vote. /end