Ellen Allen: Health care as a right only ‘radical’ in America (Opinion)

By Ellen Allen. Originally published September 2, 2025 in the Charleston Gazette-Mail.

Access to affordable and high-quality health care should be a right, not a privilege.

No one should face bankruptcy or skip essential care simply because they cannot afford it. Systems like single-payer, hybrid, or multi-payer models – used in most other countries – ensure universal coverage and help reduce inequities linked to income, employment or location. Medical debt, a leading cause of bankruptcy in the U.S., could effectively be eliminated.

As of today, most Americans – most West Virginians – have access to affordable care. While the system is far from seamless, and often fragmented, there are several options available: employer based (the primary source of insurance for most West Virginians); Medicaid; Medicaid Expansion under the Affordable Care Act (ACA); the ACA Marketplace at Healthcare.gov; Federally Qualified Health Centers (FQHCs); Free and Charitable Clinics; and public health departments.

All of these options are in place as of today, but beginning January of next year, you will see a major erosion of these options that will continue year after year. Capito Care — or the “Big Beautiful Bill” — will take away approximately $1 billion a year in health care funding. State revenue cannot replace federal dollars and services will have to be cut.

I can’t understand why Americans continue to accept the current state of health care in the United States. Why is it that every other developed nation offers universal health care, independent of employment status, while the United States — the wealthiest country in the world — still hasn’t figured it out? We don’t have to accept this.

I have family in Portugal and have formed friendships during my travels throughout Europe.
Whenever we visit, the first question we hear is: What is happening in your country? The second question is: How is it possible that every American doesn’t have access to affordable health care? That is a question I struggle to answer.

I’ve had access to health care throughout my life — on my parent’s plan, then through employer-based coverage, and now via the ACA. The Enhanced Premium Tax Credits (ePTC) make the ACA Marketplace truly affordable. Even if your household income exceeds 400% of the Federal Poverty Level (FPL), you qualify for a tax credit if your premium exceeds 8.5% of your household income.

Starting in January, close to half of my take-home pay will be consumed by health insurance premiums. Add the $10,000 in out-of-pocket costs and poof, there goes even more of my income. Thousands of West Virginians won’t be able to give up half their income and will find themselves unable to afford the cost of their health care.

Perhaps even more significant is the Medicaid Expansion provision under the ACA. Designed to help low-income adults who make too much money to qualify for Medicaid but not enough to afford private market coverage, the ACA set a national eligibility floor of 138% of the FPL.

Universal coverage or universal access — irrespective of the model — consistently results in better public health, something Americans urgently need. When people don’t fear the cost of care, they are more likely to seek preventive services and address health issues early, leading to improved outcomes and fewer costly emergencies. The evidence is clear: many countries achieve superior health outcomes compared to the U.S., and they do so at a fraction of the cost.

Even though it isn’t free to every American or every West Virginian, the framework currently in place in the Mountain State still provides nearly universal access to care.

Capito Care threatens the health of every West Virginian by making health care less accessible and affordable. And, speaking of Sen. Shelley Moore Capito, R-W.Va., don’t forget Sen. Jim Justice, R-W.Va., Rep. Carol Miller, R-W.Va. and Rep. Riley Moore, R-W.Va., also supported taking away your health care.

Let’s not forget the lessons from the COVID public health emergency. Pandemic preparedness demands a unified system that can quickly coordinate resources, testing, and treatment during national health crises.

West Virginians — and every American — deserve far better than this. We must not settle for less. It is time to demand the repeal of harmful Medicaid cuts and insist on the renewal of the Enhanced Premium Tax Credits. Our health, our families and our future depend on it.

Ellen Allen is the executive director of West Virginians for Affordable Health Care.