The youngest African-American woman in Congress, Illinois Representative Lauren Underwood, has a plan to fix health care and save the Affordable Care Act. The 32-year-old Underwood is drawing on her experience as a nurse to tackle what the majority of voters believe is the number one issue in America—the high cost of health care and the need for some form of universal health insurance. Nearly three-quarters of the respondents in a Kaiser Foundation poll conducted earlier this year said they want Congress to fix the ACA, not repeal it.
However, unlike many other prominent Democrats, Underwood does not believe that “Medicare for All” is the right answer. She is concerned about the costs of expanding government health care to cover all Americans. “If we’re going to talk about transforming our health care system in this really big bold way we should also be willing to have a candid conversation about how to pay for it and where the resources are going to come from,” Underwood says.
Representative Underwood has introduced a bill (H.R. 1868), which she says will save and expand the ACA. Under her proposal, more Americans would qualify for tax credits to help pay for health insurance premiums by extending the credits to those whose income is above four times the federal poverty level. This is because even at four times the federal poverty level, many families still struggle to pay health care costs, especially if their premiums are high. She estimates that expanding the tax credit would allow about 20 million more Americans to buy and use health care coverage. “If we make the premiums more affordable, then people can actually use their coverage,” she says. H.R. 1868 would also cap the premiums people pay on their health insurance at 8.5% of a family’s income. Currently there are many Americans who are paying three times that much and more, making insurance technically attainable, but in reality, unaffordable.
How much the bill would cost is not yet known, because it has not been “scored” by the Congressional Budget Office. However, Charles Gaba, a health care policy analyst who blogs at ACAsignups.net, estimates the cost at about $15 billion a year—a fraction of 1% of the U.S. budget of $4 trillion.
Underwood won her suburban Chicago seat in Congress by defeating incumbent Republican Representative Randy Hultgren in 2018. She flipped the seat in a district that is 85% white and that both Mitt Romney and Donald Trump won in earlier elections. She campaigned heavily on the health care issue, vowing to save the Affordable Care Act which Hultgren, while in Congress, had voted to repeal. Representative Lauren Underwood has won over Republican voters. Now she just needs to win over Republicans in the Senate.