Opinion: Rep. Andy Harris should rethink his opposition to Obamacare subsidies

I can’t say that I’m surprised that my congressman Rep. Andy Harris is opposed to his constituents being able to afford health insurance.

A few years ago, I went to his office in Washington to explain the gains of the Affordable Care Act to his staff. The first thing I noticed in the waiting area of Dr. Harris, an anesthesiologist, was his physician’s smock hanging on display. And I thought now I know how Red Riding Hood must have felt when she saw grandmother’s shawl draped over her bedpost.

Even though the first question Rep. Harris asked when he got to Capitol Hill 15 years ago was about when his Congressional health insurance was going to begin, he’s never given a whit about whether the voters who keep returning him to office can afford health coverage.

The federal tax credits that Congress approved in 2021 and reapproved in 2023 have helped double enrollment since the Affordable Care Act was created. The ACA has cut in half the number of people who don’t have health insurance in Maryland and nationwide. The political tug-of-war over whether to extend the insurance subsidies are at the heart of the government shutdown.

Harris contends the tax credits that were added a few years ago are just a “giveaway scheme” to insurance companies and were put in place solely in response to the pandemic, but that’s not true.

They began in the American Rescue Plan Act of 2021, but were extended in the Inflation Reduction Act to take effect in January 2023 as plans for the COVID “wind down” were already taking shape. The tax credits were expanded to better fulfill the “affordable” intent of the ACA for the typically low- to middle-income people who buy their own health insurance.

Here’s the thing about health insurance: Most Americans know about Obamacare only from headlines. At least 85% of Americans get their health insurance subsidized by their employer or they’re enrolled in Medicaid, seniors in Medicare or Veterans programs. Their costs for coverage are going up too, even if many folks don’t notice because few see a physical paycheck stub any more.

The ACA was created because that remaining 15% was often in the semi-wilderness of health insurance and very vulnerable to being without it.

Here’s the other thing about health insurance: If you were told that your auto insurance premiums were based on the size of the company or organization you work for, or that you’d lose your auto insurance if you lost your job, you’d think those were among the dumbest ideas you’d ever heard. But we’ve just described the U.S. health insurance system. And that is not changing any time soon, if ever, due to the might of the industry and the comfort, if not the cost, that keeps so many wedded to the status quo.

Clearly, Harris’ own constituents do not think that the added help they’ve received to enroll is so awful. Enrollment by people in Harris’ district has increased 79% from about 30,000 in 2022 to 42,000 this year. That’s tied for the second-largest jump of all eight Maryland congressional districts. You (or Rep. Harris for that matter) can look it up on the Maryland Health Exchange’s marylandhbe.com website

About 40% of those enrollees receive those tax credits that their congressman opposes so vigorously. And even the other 60% of enrollees in the 1st District benefit because more enrollees creates a healthier “risk pool” that lowers rates for all. The expanded federal tax credits that Harris’ shakes his fist against lowers health insurance bills for his constituents by an average of $79 a month. Without that help, their annual health insurance cost will rise nearly $950 for 2026, up 70%.

The GOP continues to attack the ACA even though “Obamacare” was actually President Obama’s compromise fallback plan modeled on a Republican governor’s mid-2000s approach in Massachusetts, which for years has led the nation in having the smallest share of residents who lack health insurance.

It isn’t as if Rep. Harris’ constituents don’t need affordable health and mental health coverage—far from it. Residents of his district have more deaths from cardiovascular disease than the national average, more high blood pressure and 60% greater incidence of opioid overdose death, according to the Center for American Progress. 

Perhaps Rep. Harris is oblivious to the need because his rural district is so sprawling, more than 3,800 square miles. It’s the largest by far in the state, 30 times the area of the district that encompasses Baltimore City.

But he wouldn’t have to travel beyond his home county of Dorchester to see why his constituents need relief. Dorchester has high rates of obesity, binge drinking and smoking, according to the U.S. Census. It also has a higher percentage of residents using public insurance for asthma-related emergency department visits compared to the state average. The county, the birthplace of Harriet Tubman, is fourth from the bottom in median household income in Maryland, about $60,500—exactly the community that the ACA was created to assist.

My congressman should reconsider the importance of federal support in helping his constituents and their families purchase affordable, quality health insurance.

Physician, heal thyself.

Andrew Ratner recently retired as chief of staff of the Maryland Health Benefit Exchange and resides in the 1st Congressional District.