Jesse L. Jackson Sr.

Surely, President Obama’s greatest legacy is the Affordable Care Act. More than 20 million people have received health care coverage under the act, largely from the extension of Medicaid to cover lower-wage workers and their families. Insurance companies have not only been required to deal fairly with those afflicted with ailments, they also have been forced by law to limit what they rake off in administration and profits. This is a big deal.

Lives are being saved. Illnesses are being treated. Family finances are being protected. A smaller percentage of Americans go without coverage than ever in the history of the country. This is the most important extension of health coverage since the passage of Medicare under President Lyndon B. Johnson.

Millions more, however, were turned away on the altar of meanness and ideology. So, naturally, the Republican Congress — dedicated to reversing all things Obama — has made repealing the Affordable Health Care Act, or what they call Obamacare, its first order of business. Repeal — plus the defunding of Planned Parenthood’s programs for women’s health — is the centerpiece of the reconciliation bill Republicans are pushing through Congress.

This opposition to the Affordable Care Act is founded, in large part, on racial delusions. President Obama was charged with providing health care for “those people” — people of color — at the cost of hard-working Americans. Blue-collar white voters, particularly in the Midwestern states that gave President Trump the 2016 election, were the most skeptical about the law.

As Ronald Brownstein pointed out in The Atlantic, based on data from the Urban Institute, “more non-college-educated whites gained coverage than college-educated whites and minorities combined in all five of the key Rustbelt states that flipped from Obama in 2012 to Trump in 2016: Iowa, Ohio, Michigan, Wisconsin, and Pennsylvania.”

There were stunning reductions in the number of uninsured blue-collar white people in states that President Trump won in November — roughly 50 percent in Ohio, Iowa and Michigan, 60 percent in West Virginia and Kentucky, and 40 percent in Indiana, Pennsylvania and Wisconsin.

This was largely because those states adopted the ACA extension of Medicaid to cover lower-wage workers. Where Republican governors refused to extend Medicaid, low-wage workers of all races were left out.

President Trump promised that he would not allow people to “die on the streets” with health care repeal. He also promised not to touch entitlements, which would include Medicaid as well as Medicare and Social Security. He named GOP Rep. Tom Price of Georgia to head the U.S. Department of Health and Human Services, however, and Rep. Price has detailed and destructive plans for what comes after repeal of the ACA.

He would roll back the Medicaid extension, much of the subsidies for others getting insurance in the health insurance exchanges and much of the regulation forcing insurance companies and hospitals to limit price hikes.

If he has is way, Rep. Price will also go after Medicare and Social Security as well. The result will be to strip many of the 20 million people — white people and people of color — of the health coverage they now have.

This calamity is utterly unnecessary. The ACA, as President Obama acknowledged, has flaws and is need of reform. The best first steps would be to crack down on drug company prices and to create a public option in the exchanges that would help keep insurance companies honest. Neither of these reforms is on the Republican agenda.

President Obama sensibly said while in office that he would support any Republican plan that was better than the ACA. Despite Republicans’ posturing, they offered nothing that meets that test.

President Trump’s bumptious course has made Americans appreciate even more the grace and maturity with which President Obama governed. Now Republicans, in their hurry to eviscerate President Obama’s historic accomplishment, are about to make us appreciate it all the more.

But unless a handful of Republican senators break ranks, that appreciation will come too late to help the millions of people who will be placed at risk.

The writer is founder and president of the national Rainbow PUSH Coalition.