John McCain, Cindy McCain

John McCain flashes a thumbs-up in 2008 in Phoenix, while campaigning for president. The author recalls an unforgettable hand gesture from the late Republican Arizona senator: a thumbs-down in the Senate, during the wee hours of July 28, 2017, when McCain blocked, by one vote, his party’s “skinny repeal” effort to partially scale back former President Barack Obama’s Affordable Care Act.

LENOX — It’s the vital safety net that won’t die, despite multiple maneuvers in Congress, unsuccessful efforts by conservatives on the U.S. Supreme Court and whining from the man now in Mar-a-Lago.

Remember when John McCain blocked, by one vote, his party’s “skinny repeal” effort, with his unforgettable thumbs-down in the U.S. Senate, during the wee hours of July 28, 2017?

Yes, the Affordable Care Act survives and thrives 11 years after President Barack Obama signed it into law. It’s stronger than ever, thanks to President Joe Biden. Read on for details as they affect Massachusetts residents through the Health Connector, a close relative of the ACA formerly known as “Romneycare” because the groundbreaking 2006 state law was a forerunner of the federal program.

But, first, return with us now to those thrilling days of yesteryear by recalling the scene when McCain’s turn to vote arrived.

“As the Senate clerk nodded at him, the Arizona Republican paused, then gave a dramatic thumbs down, eliciting gasps from the Democratic side of the chamber and grim looks of resignation from the GOP leadership that had spent the past few hours trying to get him to change his mind,” The Washington Post reported. “The vote left the GOP plan to repeal Obamacare in tatters.”

Fast-forward to the present, with a reminder that, while the majority of Americans are protected by workplace insurance covered on a shared-cost basis by employers, at least 30 million people are not.

Thanks to the American Rescue Plan, the federal stimulus and relief law passed last month by one vote in the Senate and signed by Biden, health care premiums are being cut for most of the Massachusetts Health Connector’s 270,000 current members and anyone qualified who signs up by July 23 to get coverage.

The subsidized health plans are a boon for the jobless, for temporary and gig workers and anyone else not covered by health insurance from employers. Outside Massachusetts, 36 states participate in the federal health insurance marketplace.

Some in our state who are newly eligible for federal subsidies will see savings of about $700 per year. Many with ConnectorCare coverage will see their premiums drop, according to Louis Gutierrez, executive director of the Health Connector.

“The changes created by the American Rescue Plan represent the most significant expansion of financial assistance since the Affordable Care Act was passed in 2010,” he pointed out.

The state agency will review the status of all members this month and in May, to ensure that they are getting the maximum amount of new federal assistance available. Any changes that result from that review will be automatically applied.

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There’s an outreach and education effort aimed at members who did not request financial assistance when they enrolled, the state’s uninsured population and people who earned too much to qualify and thus may be purchasing their own costly coverage privately, directly from insurers. Now, they may become eligible for the new subsidies through the Connector.

The bottom line: Most of the state’s 270,000 current Connector members will see lower health premiums starting next month. Others will become newly eligible for subsidized lower premiums for June coverage.

Raising the income cap will qualify for subsidies some people who earn more than 400 percent of the federal poverty level, around $51,000 for an individual, $69,680 for two people, $87,840 for a family of three and $106,000 for a family of four.

The new subsidies last for only two years, so, the Affordable Care Act needs further expansion, as Biden promised during his campaign. To make the discounts permanent, a “public option” is needed for people who want to buy into a government-run insurance plan, not only to reduce premiums, but also to cut the soaring price of prescription drugs.

Capitol Hill progressives are still pushing for a much more ambitious “Medicare for All” single-payer, government-run insurance program supported by Sen. Bernie Sanders, the Vermont independent who votes with Democrats, and U.S. Rep. Alexandria Ocasio-Cortez, D-N.Y.

Biden has yet to support that plan, and many conservatives and moderates in Congress oppose it, so, “Medicare for All” remains a potentially unachievable goal.

Besides, the Affordable Care Act remains vulnerable, since the legal campaign to undo the law continues. The U.S. Supreme Court is considering whether the entire law is unconstitutional because Congress eliminated financial penalties for Americans who fail to obtain health insurance.

But, for now, don’t miss the sale. Anyone who receives or is seeking health insurance outside the workplace in Massachusetts should invest some time on the state’s health connector website,, to sign up for discounts on premiums that, until now, have been unaffordable for many people. Some plans also offer lower copays and deductibles.

As someone who resides in the increasingly narrow “centrist” sliver of the political spectrum, I’m grateful for step-by-step health insurance progress as a realistic goal that can be achieved by a determined president and a 50-50 Senate, plus 1.

For those who celebrate … Happy Easter!

Clarence Fanto can be reached at The opinions expressed by columnists do not necessarily reflect the views of The Berkshire Eagle.