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We are members of the National Security Leaders for Biden and Harris. (<www.nationalsecurityleaders4biden.com>) We are also retired Admirals and Generals of the U.S. uniformed services, whose careers were dedicated to improving the health of Americans as Physician, Nurse and Medical Scientist practitioners and administrators in key segments of America’s healthcare systems. We have repeatedly seen the consequences from the lack of healthcare on individuals, families, and communities. Thus, we feel morally and ethically compelled to support the Affordable Care Act (ACA), the landmark legislation that was passed by Congress in 2010 and has enhanced healthcare access and financial coverage for millions of Americans.

During the past four years, dismantling the ACA has been a recurrent effort of this President, in complicity with the Republican Senate. His recent efforts have included petitioning the Supreme Court to strike down the ACA and proposing a hodge-podge of edicts to weaken and undermine its programs. All these efforts have occurred during a pandemic when Americans need health coverage and insurance now more than ever before.

What are often ignored in these efforts to derail the ACA are the real benefits of the legislation to many Americans. So from our perspective, we believe it is imperative that Americans understand the benefits they are at risk to lose. These benefits include:

o Insurance coverage, through parents, for young adults until they are 26 years old;

o Insurance coverage for pre-existing health conditions;

o Prohibitions against rescinding of health insurance when one actually becomes sick;

o Insurance coverage for immunizations, preventive screenings and contraception;

o COVID-19 insurance coverage for 20+ million Americans, who previously had none;

o Free preventive care (mammography and colonoscopy) for America’s seniors;

o Coverage for increased services for diabetes, depression, hypertension, early cancer diagnosis, end-stage renal disease;

o Discounts for proprietary drugs to cover drug coverage gaps in Medicare Part D;

o Improved health status indicators for people with prominent chronic diseases;

o Greater access to Medicaid coverage for America’s most needy in 36 out of 50 states;

o Coverage for home or community vs. institutionalized care for disabled Americans;

o Elimination of inequities of women and seniors paying the highest insurance premiums;

o Braking health cost growth rates by reforming payment rates and incentives for avoiding unnecessary re-admissions and hospital acquired complications;

o Insurance premium rebates by companies who fail the 80/20 Expenditure Rule;

o Increased payments for rural practitioners who care for 68% of America’s under-served;

o Linking provider payments to quality care, meaningful outcomes, patient experience.

The benefits of the ACA are not just for those who can now have health insurance. The COVID-19 pandemic has clearly demonstrated the magnitude and consequences of the burden of chronic diseases that plague our Country. Improving access to and quality of healthcare are important in the effort to address this burden. There are elements of the ACA that target improving the access, quality and cost of healthcare that will benefit all Americans. If you are a person who cares about the health and welfare of America’s citizens, you would seek to improve and add to this law, not try to destroy it.

Access to healthcare is one of the cornerstones to achieving health equity in America and improving the health of our Nation. But, sadly, the ACA is an anathema to factions in the Legislative Branch and to the occupants of this White House. Despite promising that he would develop an even better solution to the problems addressed by the ACA, this President has done nothing in four years to achieve his promise. If this President’s effort to undermine and overturn the ACA are successful, the health of millions of individuals and their families would be permanently harmed. Instead of leading and working towards comparable health care for our remaining uninsured 23 million+ Americans, the President is content with destroying the healthcare of the 20 million+ Americans who have finally taken steps towards achieving health equity through the ACA.

America needs a President who understands what the ACA means to 20 million+ Americans who previously could not afford basic healthcare. America needs a Commander-in-Chief who cares about the health of all Americans and seeks to unite this Country in making improved health a high priority.

America’s citizens deserve much better than our current president.

Rear Admiral (Ret) Douglas Kamerow, Former Assistant Surgeon General — USPHS, Former Director, AHRQ Center for Practice and Technology Assessment — USDHHS; Brigadier General (Ret) Clara Adams-Ender, Former Chief of the Nurse Corps — USA; Brigadier General (Ret) Kristine Campbell, Former Assistant Surgeon General — USA, Former Commander, 396th Combat Support Hospital; Rear Admiral (Ret) James Lando, Former Assistant Surgeon General — USPHS, Former Regional Health Administrator — USDHHS

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