Essential workers are invisible. The cashier at the grocery store, the nurse who tends to a sick relative, the driver who shuttles people back and forth to the hospital. We see them every day, but we don’t know their names, nor do most of us care to know their lives. But yet, these are the essential workers who allow our society to function during Covid. So we praise them. In New York, there were for months spontaneous celebrations every day at 7 PM hailing those who had put their lives on the line so we could live our lives.
Beyond our kind words, and our celebration of the contribution of essential workers, we might ask more concrete questions about our obligation to these workers as a matter of public policy. It is worth taking a moment to contemplate the meaning of “essential” in this context — these workers are essential for what, exactly? This isn’t a trick question. The answer is obvious. People who work behind the scenes, behind the cash registers, or behind the wheel providing healthcare, transportation, groceries, and pharmaceutical products are indispensable to the functioning of our society. We casually rely on them, but we fail to support them.
The flaws of our healthcare system leave so many of these workers to themselves survive on the edge of tragedy, one untreated injury or illness away from disability, one medical bill away from bankruptcy. The vulnerability of these members of our society is not simply an issue of personal suffering and individual indignity. Now is the time to see clearly. The essential functions they provide make the wellbeing of these American workers a matter of national security. We ought to protect their health with the level of policy vigor typically attendant to national security issues. Thankfully, the Affordable Care Act provides a tool for doing so: Medicaid expansion.
Approximately 5 million essential and frontline workers already receive their health insurance through Medicaid. This enables them to seek preventative care and treatment as necessary. It also means they can do so without fear of financial devastation. In the Covid era, this can mean the difference between seeking testing and treatment at the first signs of infection and ignoring obvious signs of illness to avoid financial devastation. Medicaid also ensures that those who work in healthcare, food preparation, and delivery choose to stay home when they confront mild flu-like symptoms rather than risk themselves, and by extension all of us.
However, the Medicaid expansion is not the law of the land in all 50 states, and experts estimate that an additional 650,000 essential and frontline workers would have been covered by Medicaid through this pandemic if the Medicaid expansion had been universally adopted. The failure to provide health coverage to so many of those upon whom our society has so deeply depended during this crisis isn’t simply a failure for them. We are all made more vulnerable when those we rely upon for basic needs are at risk. The expansion of Medicaid has always been the right thing to do, and this pandemic has underlined its urgency.
With over 375,000 Americans killed by Covid-19 as of writing, a rethinking of security priorities is beyond due. This should be the year that invisible viral enemies are confronted not only by vaccines but also by a corps of formerly invisible American workers who keep our essential services running all the while knowing that the healthcare system is there for them too.