Obamacare at One Year: Seven Charts Show the Law Is Working | New Republic
In the right-wing press, and among Republican politicians, Obamacare hasn’t simply failed. It’s been a catastrophe. Senator Ted Cruz regularly calls it “the disaster that is Obamacare” Wall Street Journal editorial writer Holman Jenkins, Jr., compares it to the crisis in the Ukraine. The New York Post editorial page just gave the law an "F." Its logic: "About the best thing that can be said about ObamaCare’s first year is that it wasn’t quite as bad as some critics predicted. But it isn’t even close to what we were promised — and nowhere near a passing grade."
The data tell a different story. The Affordable Care Act has real flaws and shortcomings, and pretty much any week you can find a new story about one of them. On Monday, for example, the New York Times had an article about people discovering they owe large medical bills because, during an emergency, they received care from a physician who wasn't part of their insurance network. The next open enrollment period begins in just a few weeks and, already, advocates are bracing for new glitches. But if you focus on the big picture, the available evidence suggests that the Affordable Care Act is working pretty much as its designers envisioned it would.
Critics can legitimately take issue with the law's goals and principles. That's a matter of philosophical preference, after all. Performance is another matter.
Consider:
1. More people have health insurance.
Percentage uninsured, via Gallup
Everybody knows that covering large numbers of the uninsured was Obamacare’s primary goal. And, for a while, it looked as if the law might not accomplish that. We now have overwhelming evidence that it has. The most complete data comes from a series of surveys from independent research organizations—the Commonwealth Fund, Gallup, the Rand Corporation, and the Urban Institute. Their numbers do not match up precisely, but all of them have found that, as a result of the law’s coverage expansion, the number of people without insurance fell by something like 10 to 12 million, once you add in the young adult who got coverage because of the law's under-26 provision. Meanwhile, hospitals are reporting that they are seeing fewer and fewer uninsured patients.
Those findings are not definitive and it may yet turn out that the actual reduction in coverage was higher or lower than those surveys found. The available government data, though broadly consistent with these findings, is not yet current enough to capture the 2014 expansion. But it’s impossible to argue, seriously, that the law has not meant many more people have insurance. The only question is how many and what happens in the years to come.
2. People who are getting health insurance are almost certainly better off.
It seems intuitive that people who have insurance are better off than those without. But every now and then people question it. Two recent studies should put those doubts mostly to rest. The first was a major study of Medicaid, based on data from Oregon. The authors determined that people who get health insurance from the program were significantly less likely to experience financial distress and significantly more likely to report better mental health. The one unknown from that study was whether people who get Medicaid also ended up healthier. The researchers coudn't come up with evidence to substantiate that claim.
Health outcomes, Massachusetts v neighboring states
Source: Annals of Internal Medicine
The results set off a furious debate over how much good health insurance, or at least Medicaid, did. A subsequent study, using data from Massachusetts and its expansion of health insurance, went a long way towards settling the question. The study found improvements not just in economic security and mental health, as the Oregon study did, but also in physical health. People were less likely to have severe health problems and were more likely to avoid premature death.
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More coverage.
Less cost.
Healthier people.
ACA is working!