Struggle for Americans to get health care is a national disgrace – San Francisco Chronicle

The terrain darkened as I drove the rural back roads of Georgia, red clay lining the sandy soil, deep-green kudzu choking trees and climbing telephone poles; the highway transformed into bumpy roads wearing worn-out street signs. It was summer 1985, and I was driving to see Mamie, a part-time nanny who’d helped raise me as a child. I barely knew about her own life back then, only that she lived across town, a single mom with a teenage son. I hadn’t seen her for decades.

I was now a 30-something TV reporter in Atlanta. I’d just finished a report about the “sandwich generation” — adults squeezed between caring for their children and their elderly parents — when my mom called. Mamie, she said, had moved to Georgia to care for her ailing mother.

Little did I know then that Mamie’s mother was one of 37 million Americans without health care. The idea of universal coverage wouldn’t surface until a decade later — a Clinton effort that tanked. It took another two decades before Obama signed his signature Affordable Care Act — Obamacare — into law.

Mamie was family. So, on a hot, humid Sunday, I drove west, vintage jazz on the radio. I turned off the interstate and stopped at a dilapidated roadside store. The torn screen door banged shut behind me, as ceiling fans blew a wisp of warm, muggy, air. I grabbed a bottle of cold water and asked folks standing online for directions.

After an awkward silence, a middle-aged white woman in a baggy T-shirt and faded jeans spoke up: “Y’all must be going to the black side of town.” She waved in the general direction.

As I walked out, my naiveté hit me hard. I’d grown accustomed to Atlanta politics, where most power brokers were African American: the police chief; City Council members, including civil rights legend and future Congressman John Lewis; and Mayor Andrew Young. But in the outskirts, the racial split of old emerged.

I started the car’s tired engine and drove down a dusty road flanked by sagging homes, overgrown weeds, and a spray of pines.

I pulled over at a single-story shack. Mamie must’ve heard the car because out she came with a wide smile and arms spread to embrace me. She was in her 60s by then; tall and big-boned, black hair grayed at the temples. We hugged close and then walked up a few rickety wooden steps.

Darkness enveloped the cramped quarters; no light, just a splinter of sun from the cracked front door; no bathroom — only an outhouse in the barren backyard.

Mamie’s mother, Mrs. Brown, emerged from the shadows, her frail body lying in bed a few feet away, covered in a thin, ragged sheet. Flies buzzed around her face; she was too tired to shoo them off. She had bedsores, Mamie said, and a hurt leg. I told Mrs. Brown that Mamie cared for me with a big love when I was growing up. She smiled and whispered, “That’s my girl.”

The next day, I called my contact at the state’s health agency. “This is purely personal,” I said, “nothing I’m investigating.” I doubted he could help, given the stark poverty and remote location of the Browns’ home. “Don’t you worry,” he said.

The image of frail Mrs. Brown haunted me as I waited word.

Weeks later, my mom rang. She said a nurse had started to care for Mrs. Brown three days a week. I was floored. And every weeknight, she’d get out of bed, grab her crutches, and hobble to a neighbor’s home to watch me on the evening newscast.

Relieved and grateful, I knew it was the power of TV news that compelled the state to act. But how many others were living in the shadows of poverty — from California’s Central Valley to the boroughs of New York City — lying awake, alone, without care?

Under Obamacare, uninsured rates dropped from 18 percent to under 11 percent. Nearly 20 million uninsured gained coverage. But a January Gallup poll shows a troubling trend: The rate of uninsured Americans has risen steadily since 2016 — to a four-year high. Hardest hit of the more than 27 million non-elderly uninsured: women, young adults and the low-income. In stark terms, an additional 7 million Americans lost health care under Trump, according to Gallup.

Why are millions losing health insurance? Experts cite the Republican tax law that struck down the ACA’s individual mandate; the administration’s deep cuts to the act’s marketing and enrollment budgets; and Trump’s ban on cost-sharing payments for insurers, compelling many to leave the ACA marketplace and raise premiums.

Obamacare expanded Medicaid — a salve for the poor — by increasing funds and simplifying enrollment. But many red states blocked those extra Medicaid dollars, denying benefits to tens of thousands of their own constituents. Fortunately, last year’s midterms changed that calculus: Voters passed measures in Idaho, Nebraska and Utah, among other states, to fund Medicaid expansion. Yet many Republican lawmakers are trying to delay its implementation, cripple enrollment, and reduce benefits by adding work requirements.

It’s unfathomable that untold numbers of Americans lack adequate health care coverage. For me, the face of the crisis is Mrs. Brown: a woman trapped by circumstance, financial hardship, and the vicissitudes of life. Multiply her story by tens of millions — and therein lies the enormity of the task before us.

It’s our country’s tragedy. And it’s our calling to make right.

Susan Gluss is a Bay Area freelance writer.