The Partisan Divide on Healthcare in the United States During COVID-19

Photo of the Coronavirus Task Force from The White House.

In the past few months, the world has grappled with the reality of functioning during a growing pandemic. As the United States anticipated the arrival of COVID-19, Americans watched countries like China and Italy have their healthcare systems overwhelmed by the virus. When COVID-19 eventually reached major U.S. cities, President Trump initially refused to call for a national stay-at-home order despite warnings from public health experts. Democrats have criticized Trump’s insouciant response, asserting that he acted insufficiently in mitigating the outbreak. Many Republicans, however, have defended Trump, often downplaying the severity of the virus. The American response to the pandemic has been decidedly partisan. 

On December 31, 2019, authorities in China reported a surge in pneumonia cases due to unknown causes in the city of Wuhan. Days later, a novel coronavirus strain was identified by Chinese researchers. By the end of January, China reported the country’s first death from the virus while cases were being detected worldwide. Subsequently, the U.S. reported its first death on February 28, and by March 11, the World Health Organization declared COVID-19 a pandemic.

The U.S. has a long history of partisan beliefs on healthcare policy. More recently, the national debate has centered on providing universal healthcare coverage. In 2010, former President Barack Obama signed the Affordable Care Act into law. Often referred to as Obamacare, the law was designed to increase the coverage of Medicare and Medicaid, providing insurance to an estimated 32-50 million uninsured Americans. Obamacare also mandated insurance companies to provide coverage to all people, including patients with pre-existing conditions. Republican lawmakers greatly opposed Obamacare and a former Republican congressman went as far as to call the law “the most dangerous piece of legislation ever passed in Congress.” The law’s individual mandate, requiring all Americans to purchase health insurance or pay a fine, has been deemed by Republican lawmakers to be unconstitutional and an overextension of government power. 

When Trump assumed office in 2017, he touted the repeal of Obamacare as a major part of his platform. In July 2017, Republicans introduced a bill meant to replace Obamacare that also would have drastically cut back funding for Medicaid. After the bill failed in the Senate, Republican senators added a provision to the new 2018 tax bill that repealed the most controversial part of Obamacare: the individual mandate. Despite the shortcomings of Obamacare, the idea of ensuring that all people in America have access to healthcare is well-grounded. The Republicans’ repeal of this mandate without a new plan in place demonstrates a greater concern with the optics of opposing an Obama-era policy than with actually providing people with better healthcare options.

The divide between Republicans and Democrats on healthcare has been made abundantly clear during COVID-19. The pandemic has exposed the weaknesses of the U.S. healthcare system, demonstrating the deeper systemic issue that Americans view healthcare coverage as a political debate rather than a human rights one. When healthcare policy is decided along party lines, many Americans are left without affordable options and unable to access the reliable medical care they need. Now, in the midst of a pandemic, more Americans have filed for unemployment in the week of March 29 than at any point in the last 50 years. Mass unemployment brings an unprecedented loss of health insurance that many people receive through their jobs. The current U.S. recession will worsen when uninsured Americans, battling the virus or other illnesses, struggle to pay their medical bills.

Graph from the US Bureau of Labor Statistics.

Since the beginning of the pandemic, the U.S. has been woefully underprepared to deal with a healthcare crisis of this extent. The country’s initial strategy was to test, trace, and quarantine people to prevent a future outbreak. First, people were tested to see if they had the coronavirus, and if they did, they, along with any contacts that they had in the past two weeks, were traced and isolated for 14 days. A problem with this strategy emerged right away: the Center for Disease Control and Prevention had produced a large batch of faulty coronavirus test kits. The kits had broken negative controls due to contamination in their testing reagents. With no accurate way to carry out testing, government responses were significantly delayed countrywide as doctors struggled to make accurate diagnoses. While governors and mayors attempted to obtain working tests, the number of cases rose, until states like New York and California were dealing with outbreaks beyond control. The lack of reliable testing and information led people to unknowingly continue spreading the virus in public transportation, restaurants, and work offices, causing a massive boom of cases and deaths in population-dense cities. New York City began with only 269 confirmed COVID-19 cases on March 15, but by March 31 had 38,936 confirmed cases. This extreme lack of preparation and incompetence on the part of the C.D.C. is reflective of the failings of the government at large. The Trump administration has been dismissive of their faults in handling COVID-19, claiming that they are dealing with a “bloat that occurred under the previous administration.” The President has also disbanded the National Security Council Global Health Security and Biodefense unit: a team responsible for dealing with large disease outbreaks and pandemics. Most recently, Trump has halted all funding to the World Health Organization, blaming them for “severely mismanaging and covering up the spread of coronavirus."

Compounding the problems with transmission and testing, America does not have the capacity for treatment. The U.S. has fewer hospital beds per capita than most developed countries, as well as nowhere near the number of ventilators necessary to treat severe cases if the peak projections occur. Most projections estimate that about 1 million ventilators will be needed and the U.S. only has about 165,000 ventilators available for use throughout the country. Doctors and nurses are already dealing with the effects of an unprepared manufacturing supply chain of medical equipment. A shortage of personal protective equipment has forced medical professionals to reuse everything from face shields to N95 masks. These shortages have forced hospitals to stretch resources even further, as they have had to treat their own staff who have fallen ill from exposure to patients. 

Instead of taking these issues seriously, Trump has downplayed the severity of COVID-19 on multiple occasions, claiming in late February that the coronavirus was merely “a flu.” He also made comments at one of his political rallies that he believed the virus would “miraculously [go] away” by April. These unsubstantiated claims were accompanied by a lackluster policy response. Trump refused a nationwide shutdown, stating that he believed governors should have the flexibility to decide how to implement social-distancing measures. Due to the absence of a nationwide stay-at-home order, some governors, such as Kim Reynolds of Iowa, did not have any type of stay-at-home guidelines in place until the second week of April. Governors who criticized the lack of a national COVID-19 response, such as New York Governor Andrew Cuomo, were often met by derision from Trump. Trump has repeatedly placed state autonomy over national welfare, proving to be detrimental to the country’s ability to fight the virus.

By calling COVID-19 the “Chinese Virus,” Trump has also fueled the increasing number of disturbing xenophobia cases directed towards Asian-Americans and Asians worldwide. Many Democrats, including presidential candidate Joe Biden, have said that Trump’s use of the phrase “Chinese Virus” serves to deflect blame away from his own mismanagement of the crisis in view of the upcoming 2020 presidential election. 

On the bright side, COVID-19 may force Republicans and Democrats to compromise in the coming years, in order to mitigate the negative effects of the pandemic. In some ways, this shift is already visible. Republican and Democratic senators approved a $2 trillion, bipartisan stimulus bill to address the economic devastation of the virus. Republicans even championed a portion of the bill that would grant eligible Americans with a $1,200 stimulus check directly from the federal government. Trump, who advocated for the repeal of the Affordable Care Act, has now considered beginning a special enrollment period for eligible Americans to sign up for Obamacare, addressing the growing unemployment insurance deficit. Both Republicans and Democrats must embrace progressive healthcare policies, like universal coverage and increased federal funding for hospitals, to prevent another disaster of similar proportions.

While the healthcare system appears too broken to be fixed, an amazing spirit of perseverance across the country persists. Every night at 7 P.M., the people of New York City come to their apartment windows to cheer for medical workers fighting the pandemic. As people comply with the stay-at-home guidelines, there has been success in flattening the curve. Joe Biden, now the frontrunner to be the Democratic presidential nominee, has begun advocating for more inclusive Medicare membership in response to the pandemic. These changes bring hope for  a future where universal healthcare is asserted as a human right with unwavering bipartisan support. After experiencing the aftermath of COVID-19, it is quite possible that Republicans and Democrats may find themselves more open to comprehensive and lasting healthcare reform.

Rachel Krul is a staff writer at CPR and a first-year at Barnard College studying Political Science and Human Rights. Since moving back home due to the pandemic, she has enjoyed spending time with her cat, Frank, but misses her friends and New York dearly.