Obamacare: How Effective?

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Obamacare: How Effective?

When the Affordable Care Act (“Obamacare”) was signed into law by President Barack Obama in 2010, most Democrats in Congress — nearly all of whom supported the law — predicted that it would lead to an expansion in health insurance coverage, more affordable insurance premiums, and greater access to needed health care and prescription drugs. Many Congressional Republicans, on the other hand — all of whom opposed the law — predicted that it would lead to widespread loss of health insurance coverage, soaring premiums, and less access to care.

The law has now been in full effect for over a year and a half — since health insurance coverage from state and federal exchanges began in January 2014. While that’s not long enough to evaluate the long-term sustainability of the law, it is long enough to evaluate its immediate impact. So what has the law accomplished?

Researchers sought to answer this question in a study published in The Journal of the American Medical Association earlier this year. Using a daily national phone-based survey — the Gallup-Healthways Well-Being Index — that covered over 500,000 adults ages 18–64 during the study period, the researchers looked for differences between the period of January 2012 through September 2013 (before the insurance exchanges) and January 2014 through March 2015 (after coverage from the exchanges began). As noted in a Reuters article on the study, by the end of the study period in March, Americans were reporting significantly better health and access to care than before the law went into full effect.

According to the Reuters article, the study found that in the period leading up to the first open enrollment for the insurance exchanges, trends were getting worse in the areas of insurance coverage, access to primary care and prescription drugs, affordability of health care, and overall health. The health-care law reversed these trends, and then some: About 15.8 million adults gained insurance coverage under the law, based on a statistical analysis of the survey results. Furthermore, about 11 million more adults now say that health care is affordable, about 6.8 million more say they’re in very good or excellent health, and about 4.8 million more say they can afford medicine. While the largest improvements were seen in racial and ethnic minorities — especially Latinos — all racial and ethnic groups saw improvements.

The study also found that in states that chose to expand their Medicaid insurance programs under the law to include all adults up to 138% of the federal poverty line (about half the states did this), low-income adults saw improvements in access to care. The percentage who reported being uninsured dropped by 5.2 percentage points, the percentage who had difficulty accessing medicine dropped by 2.2 percentage points, and the percentage who lacked a primary-care doctor dropped by 1.8 percentage points.

How do you feel about the results of this study — are you pleased? Disappointed? Surprised? Skeptical? Do you think these improvements will continue, or level off (or even reverse) at some point? Should improvements like these be applauded, or is it more important to point out that millions of Americans still lack insurance coverage and access to affordable care? Do you favor repealing the Affordable Care Act, and if so, what would you replace it with? Leave a comment below!

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