YO, NEW YORK IN THE HOUSE
I’m in control—never gonna stop.
Control—to get what I want.
—Janet Jackson, “Control”
Sis, Alexandria Ocasio-Cortez’s first few weeks in the 116th Congress were plenty eventful. There wasn’t a dull moment when she shuttled off on her train commute from New York to DC. By January 4 she had cosponsored her first legislation, HR 242, opposing the PAYGO Act, a “pay as you go,” budget-neutral rule where new programs that require spending by the House, either be paid by tax increases or budget cuts. What flows in must flow out, and the mantra had seemed to make sense after so many budgetary telenovelas, including the 2001 dot-com crisis that sent tax revenues flooding over and when a Republican-led House made it difficult for the Clinton administration to spend the windfall.
But now, along with other progressives, including Rep. Pramila Jayapal, who sponsored HR 242, AOC believed that PAYGO was also a way of handicapping their agenda, including their ability to mandate Medicare for All; PAYGO could make it a bipartisan issue that would be impossible to execute. Even though the bill had thirty-two cosponsors, including her friends in the Squad, ultimately the budget passed with PAYGO included. Still, her support for repealing PAYGO put her up against Pelosi and many others in the Democratic caucus—HR 242 wasn’t brought up for a vote. But like all of the Queens of Resistance, AOC went into politics with the understanding that there are times when a queen’s strength comes from her ability to break from the pack and stand on her own. As we chant, “Fight the power” Public Enemy–style, and praise AOC’s courage, the truth is, it doesn’t always come as easily as it looks, and on the Hill she almost daily must face the scrutiny of her colleagues. And PAYGO was one fight she didn’t win.
But there would be more rules to follow and more to resist. And even though this first challenge didn’t succeed, AOC’s new colleagues were impressed. She was making a statement on the Hill—that she was coming in questioning everything and everybody, certain that age-old authority and rules would be unpacked, and she wasn’t just going to be polite and follow the sheep if she believed it could hinder progress. Because she was there for progress, ya know!
JANUARY 4, 2019, was a busy day for our queen. On the same day as the PAYGO challenge, AOC was assigned to the House Oversight and Reform Committee, the main committee that regulates the administration and became the spearhead for impeachment, then chaired by the late, deeply respected Rep. Elijah Cummings. Several of the progressive new members were placed on the committee along with her, including Ayanna Pressley, Rashida Tlaib, and Katie Hill. Cummings liked these new young members. He admired their energy and intelligence, and wanted to put them under his wing. AOC was also put on the House Financial Services Committee, led by the first woman chair and fellow Queen of the Resistance Maxine Waters, who also signaled her willingness to mentor an up-and-coming firebrand. AOC also wanted to be placed on the powerful Ways and Means Committee, but she didn’t get the nod.
Still, there were plenty of opportunities to make waves in the committees she was placed on. The House Oversight and Reform Committee is the investigative body of the House and would be the committee to open investigations on Trump and his administration. It also investigates other major issues Americans face, like skyrocketing healthcare costs, which was a major issue for our queen—more on that soon. Let’s just say, it was on!
Still, the media and some of her new colleagues whispered about how this new Cardi-B-bopping freshman member (if they even knew who Cardi was) would conduct herself in congressional hearings. How prepared would she be? Would her lines of questioning be targeted enough? It was ridiculous talk.
Yet AOC is a queen because she keeps it 100. She would remain just as transparent as she had been during her campaign. With the country and her constituents watching, she shared her insecurities about the days ahead in her new job and what we’re sure turned into sleepless nights about whether she’d screw it all up or not—common moments for anyone repositioning herself for a big new role. AOC doesn’t want other women to think she’s Superwoman. She wants more than anything for women to know they can and should do it too. She was honest about her learning curves and public about her insecurities as a new girl on the Hill. She didn’t wait twenty years to write a political memoir; she knew that other women needed to know the real deal right away.
In fact, she let us know the details like no other. When she joined with the committees she shared the ins and outs of her new job in a Twitter thread and gave us the tea on Congress. “This week our 1st-ever Committee meetings and our 1st-ever Hearings of the 116th Congress (the oversight hearing was on the skyrocketing costs of prescription drugs). It’s always intimidating to speak up in a new setting. In Congress, we abide by strict rules of communication, particularly in committee. For example you’re supposed to address the chair, and speak in the third person when referring to your colleagues. Breaking those rules can have consequences small and large: not knowing how means you could lose precious speaking time, or miss an opportunity to make a point. Opposing party members are always looking for the slightest slip-up to gum up process or make an example of you.”
Well, dang, that doesn’t sound so fun. That sounds stressful! We knew already that AOC came in ready to advocate for her constituents and to encourage bold, progressive change . . . but first she did need to learn how the process works, just like all the other newbies.
But AOC says that she fights all of that noise by knowing how to communicate with her fear. Though the House environment is scary, she admits, she also saw it as a galvanizing force. As she says, “Fear, a lot like discomfort, forces us to choose: ‘Do I do this, or not?’”
And thank goodness AOC and other queens are not afraid of some little roller-coaster moments, and neither should you be. If it’s for the good, choose to do it.
By August 2019, she was already using her voice in a powerful way to discuss healthcare. “When I was sixteen years old, my father was diagnosed with a rare form of lung cancer,” she said at a prescription-drug-prices hearing held by the House Oversight and Reform Committee. “He was in experimental trials in order to save his life. My family almost lost our home in order to try to keep him alive and just try to keep our family together.” With that personal connection, she was bringing big issues in front of voters and getting people excited about change in policy issues that they may not have thought they could have any power in. She was living proof that they could, either by running for office themselves or by getting the right elected officials to fight for them.
It was the same energy she’d brought to her door-knocking days during the campaign, but now she was connecting with people via her story on a national scale. Healthcare issues were why AOC, a college-educated millennial, was working behind a bar when we met her. It wasn’t because she just thought it would be fun to work behind a bar (not that anything is wrong with working behind a bar!). But something was wrong with the fact that she was working there because she’d had a loved one get sick and her family was thrown off course financially.
The United States is the only developed nation that doesn’t guarantee universal healthcare. If AOC had lived in France or Ireland, her dad would have been cared for without that financial strain. If she’d lived in Demark, Italy, Austria, Germany, Japan, Costa Rica, Thailand, Brazil, Peru, and other places you vacation, he would have been covered. Medical bills are the number-one reason that Americans file for bankruptcy. Let me tell you something right now, sis: many Americans are paying their accumulated medical bills with credit cards, which then leads to a low credit score and converts into a years-long stumbling block for any future personal growth . . . and, oh, there’s the fifty trillion phone calls coming from collection agencies. While people are trying to heal, the money stress itself is sickening.
Unfortunately, a risk of a health issue—from the minor to the major—can be catastrophic and life-altering in more ways than just physical health. People without insurance are the ones who pay the most for healthcare. They don’t have insurance because they can’t afford it or their employer doesn’t provide support. These uninsured people are not just low-income service workers; the uninsured also include entrepreneurs, small-business owners, artists, and people whose employers keep them on only as contractors or part-time employees. A Harris Poll found that 54 percent of Americans delayed getting healthcare. “Making it” is a struggle, as we know, and it’s more than an emotional burden when any sneeze or sniffle is a possible financial threat. Many people just decide to never acknowledge getting sick, period. “Oh, Mami, it’s just a cold that has been in my system for two months. No biggie.” The poorer she is, the less likely she is to be cared for. It’s a decision whether to shuffle along, sick but free of medical debt, or to seek treatment and be exposed to another kind of risk.
“I was uninsured seven months ago,” AOC said to the committee on the day of that hearing. “It’s not just a financial issue. It is the stress . . . everything becomes a spiral [of] anxiety because you don’t know how you’re going to afford it . . . I rationed my own healthcare for ten years . . . We are rationing our own care.” Right before she became congresswoman, AOC, while living in Parkchester in 2017, reported annual earnings of around $26,581. That means if she purchased health insurance, she would have had to pay approximately $160 per month. AOC once tweeted:
Pretty sure one of Dante’s Circles of Hell includes scrolling through a mirror-hall of agonizingly similar healthcare plans like “UHG Choice Master HMO 1800” vs “RedGo Option Plus EPO 2000.” I don’t know one normal person in this country that actually enjoys open enrollment.
At least if people could go to the doctor and feel financially “safe,” there could be more preventative care. A blood test or even annual visits to the doctor for physicals and checkups could stop millions of us from acquiring serious illnesses. Instead, people are forced to delay their care. Instead, many people wait until they have to be hospitalized before treating their ailment. Emergency rooms are often full of people who are uninsured, either because they’re unemployed or working hard at low-paying gigs or institutions that don’t support their care. If they had health insurance, they could go to a regular doctor’s office, but without it, the ER is their only viable option.
By law, hospitals must provide medical care to uninsured individuals. However, doctors are not required to offer care to uninsured people; so there won’t be any follow-up care unless they have the Benjamins to pay out of pocket.
These inequalities, as with pretty much all systems of inequality, disproportionately affect people of color. Twenty-one percent of Hispanic people were uninsured in 2015, and 12 percent of Black people—only 8 percent of white people. Many Black and Latinx people die due to heart disease and diabetes at alarming rates—both preventable diseases if tackled early, deadly when untreated. Black people have the lowest life expectancy in the nation. The death rate of Black people was 1.2 times higher than white people in 2014. These are the dark, ugly consequences of our healthcare system that political warriors like AOC are fighting to abolish.
To combat this system, AOC is fighting for Medicare for All. Americans young and old are fed up with the sky-high bills and maze of networks—not to mention the knowledge that their hard-earned money is going into the pockets of insurance company CEOs. Medicare for All would mean the end of that for-profit system. Call it socialism, call it leftist thinking, or whatever, boo, AOC is fighting not for the name but for lives. She’s experienced it, she had to clean toilets because of it, and now she’s in public service to fix it.
But let’s back up for a minute. Of course, President Barack Obama took a similar leap more than a decade ago with Obamacare, the nickname for the Patient Protection and Affordable Care Act (ACA for short). It offers access to healthcare and insurance to reduce healthcare spending in the United States through a number of regulations, taxes, tax breaks, mandates, and subsidies. A whole lot of issues have been addressed. There are now regulations where insurers can’t deny insurance to sick people, or those with preexisting conditions. Before Obamacare, if you were, let’s say, a breast-cancer survivor who lost your insurance, it was almost impossible to get new insurance. It was easier—and more profitable—for companies to insure a person in perfect health. This is what happens when profit drives the conversation about our health.
Other benefits that Obamacare brought included: subsidies, assistance from the government with out-of-pocket costs and health-insurance premiums; a mandate for everyone to be insured, an official order from the government for large employers to provide health insurance to their full-time employees; and taxes on those pharmaceutical and drug companies who profit off the sick. Young people were able to remain on their parents’ insurance until they were twenty-six years old. Insurers couldn’t deny coverage or care, or charge higher premiums to those with preexisting health issues. It expanded mental health and addiction coverage, including screenings for depression and behavioral assessments for children, at no cost. It isn’t perfect, but it protected Americans.
But where is Obamacare now?
Well, there is what is known as Trumpcare, the healthcare reform of Obamacare under Donald Trump. He started his administration with an effort to repeal and reshape the original plan with a cheese-head’s agenda. The GOP-controlled House and Senate came dangerously close to passing a plan that would have sent us way back to the bad old days when it came to healthcare, but thankfully the American people flooded their local town halls and slapped down that effort, hard.
Still, the Republican-led 115th Congress had been able to undermine the existing system: narrower networks and shorter enrollment periods, making it harder to participate in the program for people who need it; cuts to cost-sharing reduction assistance payments for insurers that provided help to those with lower incomes; changing coverage for birth control so religious employers don’t have to cover contraceptives; and allowing individual states to implement work requirements for Medicaid.
A bogus, whackjob plan, just like its owner.
In the decade following its passage, the ACA allowed twenty million people to gain health insurance, and eleven million to obtain Medicaid in thirty-one states. Looking to the future, Alexandria the Great is going after Medicare for All to create a single-payer healthcare system. She tweets, “People don’t want overly complicated choice[s] between pricey, low-quality plans. We want an affordable solution that covers our needs, like the rest of the modern world. Medicare for All:—Single-payer system—Covers physical, mental, & dental care—0 due *at point of service.*” Medicare for All allows for universal health coverage at a lower cost.
While she was once estimated to pay about $160 per month for insurance in 2017, today she and fellow Congress members can pay less than $80 a month and get to keep that insurance for life. It’s a perk that ensures top-notch healthcare to those serving our country, but like her dad, AOC lives by the idea that if I eat, you eat too. “It’s frustrating that Congress members would deny other people affordability that they themselves enjoy. Time for #MedicareForAll,” she tweets.
Shoot, she needs pharma to step up their game too. AOC’s from da Bronx and will fight so that all people have access to safe and affordable prescription medication. AOC pushed this agenda forward during the Congressional Oversight and Government Reform Committee investigation of the pharmaceutical corporation Gilead in May 2019.
Gilead produces an HIV-prevention drug known as Truvada for pre-exposure prophylaxis (PrEP) that is available globally. Taking it daily can drastically decrease the chances of contracting HIV-1 in people who are HIV negative, which is a game-changer, especially for the LGBTQ+ community. The problem is that the drug is prohibitively expensive for Americans, despite the fact that it was developed and patented in the United States. A quick comparison: Many in the United States need to pay more than $1,700 per month for Truvada, while it costs $8 per month in Australia, where it’s available as a generic drug. What?! This is what happens when a government doesn’t keep up with other developed nations on social programs like universal healthcare: everyday people are often unable to take a potentially life-saving drug, and the company gets to swim in cash like Scrooge McDuck. In 2018, Gilead made $3 billion in revenue globally.
AOC drilled the CEO of Gilead in the hearing. “This isn’t about you as an individual or your character. This is about the system on incentives that you have set up. When it comes to who to blame for this, I don’t blame you. I blame us. I blame this body, because every single developed country in the world guarantees healthcare as a right except us.”
Now, thanks to the persistence and badass elected officials, including AOC, a generic version of Truvada will be available a year earlier than planned. This benefits individuals who can’t afford the brand-name drug, but also everyone in the nation because the boost to public health created by accessible preventive care will save taxpayers billions.
A QUEEN SPEAKS up. AOC shows that it’s time to be the loudest woman in the room about what we want to see. One should be able to go to the dentist without worrying about the rent, or student loans, or even her sneaker budget. Healthcare should be a given.
Many hardworking citizens would love a smile like AOC’s, which gleams out at you in her official House photo and all over Instagram. The problem is the money stress associated with going to the dentist. One could go in for a regular cleaning, even with her employer insurance, and walk out with clean teeth and a $200 debt. Shoot, forget it if she was hyped about going to the out-of-network dentist that her coworker recommended—that bill could skyrocket up without coverage.
And this is only one example. What about more serious diseases, ailments, or injuries that can’t go untreated? AOC got into politics to fight with us and get us out of these holes. Some of us will be better at writing letters the old-fashioned way, others will go to town hall meetings to speak with elected officials in person, and others will take to social media with a fierce finger or live video from their phones. But whatever the method, AOC helped this generation understand that whatever you do, you be sure to clap back.