PolitiFact has looked at the data available so far on the Affordable Care Act. They confirm what I’ve said in many posts on health care reform. ObamaCare is leading to more people being insured, lower costs, and a reduction in the deficit. The various Republican predictions of doom have failed to come about. The one area in which the law failed to meet expectations was the number of people covered due to Republican-controlled states which do not participate in the expanded Medicaid program. Thank-you Republicans for once again showing that you are the anti-life party.
Here is a summary of what PolitiFact has reported:
In 2010 it was projected that by 2019 32 million people would gain insurance, leaving 23 million uninsured (with the uninsured including illegal immigrants who, despite that email from your crazy Republican uncle, are not covered under ObamaCare.) It is now projected that by 2019 27 million will gain insurance, leaving 26 million uninsured. This is largely due to those not receiving access to the expanded Medicaid program in Republican-controlled states.
In 2010 it was predicted that the Affordable Care Act would decrease the deficit by $143 billion between 2010-19. In 2014 the projection was updated to reducing the deficit by $152 billion between 2015-24.
In 2010 the cost was projected to be $710 billion between 2015-19. The updated projection is $571 billion. The lower estimate is due to both reductions in health care costs and decreased spending on the expanded Medicaid program.
PolitiFact debunked that Republican claims that the Affordable Care Act is a jobs-killer.
PolitiFact debunked the Republican predictions of a death spiral in which premiums would become more expensive and younger, healthier people would not purchase insurance: “About 28 percent of customers during the 2014 enrollment period were ages 18 to 34. And there were 70 more insurance companies participating in the 2015 marketplaces than the previous year…”
PolitiFact debunked Republican predictions of increasing premiums, noting a decrease in health care spending. It is not clear to what degree this can be attributed to the Affordable Care Act versus other factors. One aspect that is not measurable is the way in which the culture in health care has changed since Obama began speaking about health care reform, leading health care professionals to utilize resources more economically.
The Affordable Care Act was introduced as incremental legislation which would both increase access to care and reduce costs. It was never expected to lead to universal coverage without further expansion of the plan. PoltiFact looked at those projected to remain uninsured:
Who makes up this group of persistently uninsured? About 30 percent are illegal immigrants, which the law specifically does not apply to. But about 40 to 45 percent are people who will choose not to purchase insurance offered to them either through the marketplaces or through an employer, in many cases because they still can’t afford it. The law exempts people from paying a penalty who have incomes so low they don’t file tax returns.
There is also a coverage gap unintended by those who wrote the law: People who live in states that didn’t accept Medicaid expansion. The law essentially required states to expand eligibility and agreed to pay 100 percent of the expansion for the first three years, declining to 90 percent in 2020 and beyond.
One goal for the future is to provide assistance for those denied care due to living in Republican-controlled states. Further review of the law is needed regarding the 40 to 45 percent who are projected to remain uninsured due to choosing not to purchase insurance offered through the exchanges or employers. Some people are not obtaining coverage due to believing false information spread by Republicans and this problem will hopefully decline as more people see the success of the law. Some were unaware of the tax penalties as they will not experience them until paying taxes due this April 15. This might provide further motivation to obtain insurance.
The biggest concern are those who remain unable to purchase insurance due to the cost. As I previously noted, eighty-three percent of enrollees qualified for subsidies in 2013. Those who qualified payed an average of $82 per month in premiums. Those obtaining Silver plans paid an average of $69 per month. Those not obtaining coverage due to the cost are probably people at the upper income range for receiving subsidies and not receiving sufficient subsidies to afford insurance, or those who just miss out on qualifying. This situation might be improved with further reductions in costs but expansion of the subsidies might be needed to get closer to universal coverage.