Andy Slavitt

Opinion columnist

From the day I left the Obama administration in January, I have been haunted by a scenario I didn’t want to imagine was ever possible in this country — the loss of health coverage and deterioration of the Medicaid safety net that was at the heart of every Republican health care proposal. Having overseen the Affordable Care Act, Medicaid and Medicare, I thought I knew these programs well. But my travels over the last six months taught me a lot more about the families whose lives depend on them, and how tightly Americans’ connection to the middle class is tied to their access to affordable care.

I ended up face to face with a family fearful over what it would mean to lose pre-existing conditions protection for their child now in remission from cancer. I talked to a woman in Minnesota whose mental illness was controlled by medication she was finally able to afford because of the ACA. A young man in Ohio told me that there were no jobs in his neighborhood offering insurance, and that the ACA’s expansion of Medicaid was providing the first access to regular care for many of his friends.

More:GOP 'health' bill isn't about health. It's about winning and job protection.

More:Trump is playing health care games with lives. Where are the grown-ups?

I had known these things, but the more time I spent walking near the shoes of these people, the more it became clear to me: Proposals aimed not at improving the ACA, but at taking away money from care for working American families, had to be stopped.

Everywhere I turned, as I listened to people's stories, I heard another fainter, but still distinct, note. When and how do we make the cycle of partisanship stop? One thing I’ve learned is that the desire to have a regular source of care and not worry about going bankrupt from a medical bill is not a partisan sentiment, it’s a human one. And when the human system depends on the vagaries of who’s in power in Washington, no one can sleep well at night.

President Trump is on a different page. He is still goading his party to run over rather than work with Democrats. He also has repeatedly expressed his intention to do real damage to the insurance markets, and he possesses the arsenal to make it happen. He may follow through as soon as this week on his threats to cut off subsidy payments that make health care less expensive for low-income people. Members of Congress, in both parties, ought to use every tool they have to hold him accountable for delivering for the American public.

Any long-term solution for our country lies at least in part in an end to the epic partisan battles. When I left government, I began to regularly visit Washington and other parts of the country to meet with Republican counterparts and trade ideas with policymakers, state officials and policy experts from both sides to look for common ground. As I advocated against a bill I believed would harm our country, I found it challenging to listen to people who disagreed with me, and sometimes I was too dismissive of their points.

There is no lack of pragmatic ideas on how to make health care more affordable and accessible, but we often get so hemmed in we don’t listen. Supporters of the ACA need to understand that for all its successes, there are people who feel left behind and are struggling with high costs.

For bipartisanship to work, Democrats need to be more open to Republican ideas, such as giving states more flexibility to create their own solutions. Republicans should focus not on cutting money for health programs, which just shifts burdens to states and consumers, but on real structural changes — and recognize that Americans want improvements in the law, not a complete do-over.

More:Anthony Scaramucci's aggressive incompetence

POLICING THE USA: A look at race, justice, media

Finding bipartisan solutions is not an impossible dream. This month, for example, I wrote a paper for the Journal of the American Medical Association with Gail Wilensky, a former George H.W. Bush health official. We laid out a commonsense set of approaches to Medicaid reform that have potential appeal to both parties.

We can’t have a system where one party is pulling on one side of the rope and the second party on the other, and expect to get anywhere. If the party in charge calls all the shots and the minority party reserves the right to find fault or create mischief, our health system will be in limbo and our politics will remain broken. And we can't change our health care system with each election. Both sides should agree to avoid fast-track processes that allow one party to be excluded from the debate, and both parties should agree to take half a loaf if, in the end, everyone owns the outcome.

Families I’ve heard from since the collapse of the Senate health bill last week feel safer with the ACA intact. But it will take bipartisan support of health care — not called Obamacare, not called Trumpcare — for Americans to feel truly secure. Sometimes, it takes partisanship to fall flat for bipartisanship to rise. We would be wise to seize this moment.

Andy Slavitt, a member of USA TODAY's Board of Contributors, is a former health care industry executive who was acting administrator for the Centers for Medicare and Medicaid Services from 2015 to 2017. Follow him on Twitter: @ASlavitt

You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @USATOpinion and in our daily Opinion newsletter. To respond to a column, submit a comment to letters@usatoday.com.