In the time of COVID, a shot of hope -- Feb. 11, 2021 column

By MARSHA MERCER

I got my first dose of the COVID-19 vaccine this week and felt a surge of relief, gratitude and irrational exuberance.

Irrational because a first dose is just that. A second dose of the Pfizer vaccine is needed three weeks later for full effectiveness. Plus, we don’t know if someone fully vaccinated can spread the coronavirus.

I never expected to get misty over a shot, but I did. Months lost to waiting and worrying about COVID-19, the unpredictable, deadly disease that has upended all our lives, could be nearly over.

Millions of Americans are lining up every day and rolling up our sleeves to get something that literally could save our lives. We are so lucky.

Lucky all the pieces of the puzzle came together. Vaccines are available, and we trust them. We were able to sign up online, and we could get to a vaccination center at the day and time specified.

I pre-registered for a vaccination through the Alexandria Health Department one month and a day before I received the shot.

Yet not all Americans are lucky enough. People in rural areas who lack the Internet or transportation to a vaccination site can, and are, getting left behind. This must change.

At George Washington Middle School in Alexandria, kind and efficient medical staffers wearing masks and plastic shields took my temperature and asked the now-familiar screening questions about exposure to the coronavirus.

I received an orange slip of paper and stood in another short line in the gym until someone at one of the many tables waved me over with a green “READY” sign. After I got my shot, which I hardly felt, staff asked me to wait 15 minutes in case of allergic reaction. Like most people, I had no reaction at all.

“Your arm is going to be sore -- not right away. Probably tomorrow,” the nurse told me. “But that’s OK.” She was right. The soreness didn’t last.

The COVID-19 vaccination delivery system is finally working.

I also signed up online for my elderly dad who lives in Richmond. He got an appointment a couple of weeks later in January. The contact person said everyone on her call list was 88 to 99 years old.

I drove my dad to the center, and we were able to wait in the car until the shot came to him about 45 minutes after his appointed time. I was so grateful we didn’t have to use the wheelchair I’d borrowed – and grateful for the man who helped direct traffic and then went car to car, offering a prayer to each.

But vaccination delivery varies greatly depending on where you live. A friend’s mother has spent many hours on the phone, trying to book appointments for herself and her mother, who’s in her 90s. The experience left her in tears of frustration and anger.

More than 470,000 Americans have died from COVID-19, among them about 100,000 in the last month. Millions have lost their jobs and businesses. And yet, with the rollout of vaccinations, there’s hope.

The number of COVID-19 cases, deaths and hospitalizations nationally is dropping, though it’s still high.

President Joe Biden appears likely to meet his goal of 100 million shots in his first 100 days. About 1.5 million shots are being given daily, reported the White House, which is expanding doses and vaccination sites.

Experts say 70% to 90% of us need to get vaccinated to achieve herd immunity, when most of the population is immune either through having had the disease or vaccinations. More outreach is planned to Blacks and Hispanics, who are wary of the vaccines.

As more people get vaccinated and tell their friends and family, others are more likely to want vaccinations, surveys show.

“Perhaps more important than any message is the impact of seeing a neighbor, friend or family member get their shots without any adverse effects,” Kaiser Family Foundation President and CEO Drew Altman said, releasing a KFF COVID-19 Vaccine Monitor survey Jan. 27.

About half those who want to get vaccinated as soon as possible know someone who has already gotten a dose.

I plan to get my second dose when I can. I urge you to roll up your sleeve, too. We can do this. We must.

©2021 Marsha Mercer. All rights reserved.

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Health insurance for millions in peril -- Nov. 5, 2020 column

By MARSHA MERCER

With the future of health care in limbo during the prolonged presidential election, the Supreme Court next week will take up a case that could yank health insurance from 23 million Americans during a pandemic.

On Tuesday, the court will hear oral arguments in California v. Texas, which questions whether the Affordable Care Act, a.k.a. Obamacare, is constitutional. What the court ultimately decides could affect nearly every American family, not just those who buy their insurance through Obamacare.

Republicans have long argued Congress overstepped its authority when it imposed the individual mandate, requiring most Americans to buy health insurance or pay a penalty.

In 2012, the court upheld Obamacare 5 to 4. Chief Justice John Roberts, siding with the more liberal justices, wrote that since the penalty was collected by the IRS, it could be considered a tax and Congress has the power of taxation.

In 2017, Congress zeroed out the penalty. A group of red states challenged Obamacare, arguing a zero penalty means there is no tax and the law is unconstitutional. The Trump administration backs the red states.

After rounds in federal courts, a group of blue states supporting the law asked the Supreme Court to review the issues. The House is also defending the law, which remains in effect.

This time, conservative justices hold a 6 to 3 advantage. In a sign of the significance of the case, the court has lengthened arguments from the usual 30 minutes to 40 minutes for each side side.

Tuesday’s arguments may give us a glimpse into the mind of Justice Amy Coney Barrett, who said at her confirmation hearing, “I am not hostile to the ACA,” although as a law professor she wrote an article criticizing Roberts’s reasoning in the 2012 decision.

The current case raises the doctrine of severability -- whether a law can still stand if part of it is struck down. Barrett said she has not talked or written about severability.

The highest court could let Obamacare stand, abolish it entirely or do something in between. A ruling is expected by summer.

No one argues Obamacare is perfect. Many Americans bristled at being told they had to buy insurance, at paying a penalty if they failed to do so and at the cost.

But. Under Obamacare, insurance companies may no longer deny coverage to people with preexisting conditions like cancer, diabetes or sleep apnea; charge them higher premiums, subject them to long waiting periods or cap their benefits.

About 54 million Americans under 65 – or 27% -- have a preexisting condition that, before Obamacare, insurance companies could use to decline coverage on the individual market, an analysis by the Kaiser Family Foundation found. In Virginia, about 1.3 million people under 65 – or 26% -- have such conditions, the report said.

Besides protecting those with preexisting conditions, Obamacare also prevents insurers from charging women more than men, permits children to stay on their parents’ insurance policies until age 26 and offers subsidies to some customers to help pay premiums.

Most Americans get their insurance through their employers or a government program like Medicare or Medicaid, but no one knows when a job loss, divorce or other life event may require buying insurance on the individual or non-group market.

The pandemic and economic downturn prompted an additional 3 million Americans to seek help, raising the number covered under Obamacare to 23 million, according to the liberal-leaning Center for American Progress.

In the absence of Obamacare, COVID-19 could be considered a preexisting condition, and survivors could be denied health insurance.

President Donald Trump has promised since 2016 to repeal and replace Obamacare with something better and cheaper but has never presented a replacement plan.

He issued an executive order on preexisting conditions in September that experts said was symbolic and had no practical effect.

Obamacare has withstood more than 70 Republican attempts at repeal in the House and many judicial challenges.

Before the election, when it appeared the Senate and White House might flip blue, both Democratic presidential nominee Joe Biden and House Speaker Nancy Pelosi said they would work to strengthen Obamacare.

A Republican Senate led by Mitch McConnell makes meaningful change more difficult and raises the stakes for what the court decides.

Republicans and Democrats need to work together to write a law that works and people will accept. America will be healthier for it.

©2020 Marsha Mercer. All rights reserved.