Five years after most of the provisions in the Patient Protection and Affordable Care Act (ACA) came into effect, the health care law is still a political hot button issue that has been embroiled in legal challenges since President Obama signed it into law in 2010. Republicans have tried multiple times – unsuccessfully – to repeal the law. The U.S. Supreme Court has upheld the ACA in two previous challenges, and it now appears to be headed for a third review, with Vermont joining a multi-state coalition seeking to uphold the law’s constitutionality. In the meanwhile, the Vermont House has introduced legislation (H.129) calling for universal primary health care in Vermont by 2023.

Despite impressive gains in health care access since the ACA’s implementation, the law did not go far enough, as it did not achieve universal, equitable health care coverage. From a public health perspective, we should build on the successes of the ACA by moving toward Medicare for All in order to finally achieve universal, equitable coverage.

Paying for such a system is always contentious, and that is a hurdle facing H.129. However, as the bill’s lead sponsor noted, “By investing in universal primary care, we can improve population health … save lives and save money.” Numerous studies have shown that this could happen at the federal level, also.

I applaud our progressive Vermont legislators for renewing the call for universal primary health care in our state. Perhaps this time around, we can provide a model for the rest of the nation.

Audree Frey

Underhill

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