Our first concern must be health coverage for those with none

Photo by Hush Naidoo

Then we can improve coverage for millionaires and billionaires

With some history lessons in mind, I have been sounding the alarm as Congress works to put together the Build Back Better Act, a comprehensive bill to invest in American families.

Together with the bipartisan Infrastructure Investment and Jobs Act, this legislation would be a significant step toward fulfilling the campaign promises that President Joe Biden and Democrats ran on during the last election cycle. These promises—if kept—will turn the tide on some of the growing inequities in this country.

Some have equated President Biden’s Build Back Better agenda with President Franklin Roosevelt’s New Deal. While those making this comparison view the New Deal as a positive model to be emulated, I caution that there were shortcomings in the New Deal that left significant numbers of people and communities behind.

We are at risk of repeating those shortcomings. The New Deal did a lot of good for a lot of people. But for many people and communities, some of which I currently represent, the New Deal was a raw deal. 

Let’s take Social Security as an example. This transformative program helped lift many seniors out of poverty. But when the legislation was written, the decision was made to set the Social Security retirement age at 65 and leave out farm and domestic workers. 

According to the 1930 Census, 65% of African Americans were employed on farms or as domestic workers, and the life expectancy of Black workers was 48 years. The New Deal perpetuated second-class citizenship for Black communities and effectively institutionalized the wealth gap.

We risk repeating that history today, as many of the same people and communities left out of Social Security are now at risk of being left out of healthcare coverage due to the refusal of Republicans in 12 states—eight of which are in the South—to expand Medicaid under the Affordable Care Act. 

As a result, 2.2 million uninsured Americans living in poverty are within the so-called coverage gap without assistance to help them get covered. Sixty percent of them are People of Color.

I have been vocal about ensuring that we address this injustice as we structure the Build Back Better Act. I am imploring my colleagues to address the racial inequities exposed and exacerbated by COVID-19. This is not a red state/blue state issue. This is a moral issue for all Americans. This is our opportunity to address the systemic inequities.

There are numerous worthy priorities under consideration for inclusion in the Build Back Better Act. Given the unwillingness of a few of my colleagues to support sufficient funding for all of them, Congressional Democrats are in the process of making difficult decisions about which to include. Some argue that expanding Medicare is more important than closing the Medicaid coverage gap. I beg to differ.

While I fully support expanding Medicare, if forced to choose between the two, I would prioritize healthcare coverage to low-income Americans who have no coverage at all over additional health coverage for millionaires and billionaires, who already have basic Medicare. If both can’t be funded permanently, at the very least, the two should be treated equally.

Last year during a closed-door meeting, I expressed to my Democratic Caucus that “We have an opportunity to restructure things to fit our vision.” My comments were leaked to the press and roundly criticized by some of my Republican colleagues. But I stand by them.

We Democrats extoll America’s vision of “liberty and justice for all.” Currently, low-income Americans in the 12 non-expansion states are being unjustly denied the liberty and justice that comes with having access to health care. 

The Build Back Better Act gives us an opportunity to fit America’s vision by closing the coverage gap. Remembering and learning from past failings, let’s fix this inequity.

James E. Clyburn (D-SC) is a U.S. Congressman from South Carolina representing the 6th District.