Ned Barnett

A healthy year for ‘Obamacare’

The Affordable Care Act didn’t get much of a celebration for its one-year anniversary Oct. 1. Democratic politicians, as is their skittish style these days, tended to ignore the occasion. But, tellingly, so did their Republican counterparts.

Sure, Karl Rove’s American Crossroads group released a video full of quotes from President Obama, North Carolina’s U.S. Sen. Kay Hagan and other Democrats saying, “If you like your plan, you can keep it.” And Hagan’s Republican challenger, state House Speaker Thom Tillis, reflexively put out a statement saying that the law “created a nightmare for millions of Americans who received cancellation notices and saw their health care premiums skyrocket.”

But mostly, there was silence. The “Obamacare” issue that was supposed to be the issue as voters go to the polls in less than a month has quietly become a non-issue. And the reason is a simple one: It’s working.

The New Republic marked the ACA’s anniversary with a list of seven charts that show the health care law’s success based on statistics and studies. The findings:

•  The number of uninsured people in the United States was reduced by more than 10 million, and hospitals are reporting fewer uninsured patients.

• People who have obtained health insurance for the first time reported feeling more economically secure and less mentally stressed.

• According to a Kaiser Foundation survey, nearly half of those who “lost” their coverage because it was noncompliant with the ACA ended up with better coverage at a lower cost because of tax credits.

• Insurance premiums aren’t rising quickly and in some states are declining. Meanwhile, more insurance companies are competing in the exchanges.

• The ACA did not drive up employer premiums. A Kaiser/HRET survey found employer premiums rose by only 3 percent, close to the rate of inflation.

• The rise in overall health care costs has slowed. The recession and its aftermath explain some of that, but the ACA is also helping by imposing penalties for hospital re-admissions and other cost controls.

• The Congressional Budget Office says the ACA cost $36 billion in 2014, $5 billion less than projected. The CBO also lowered the projected cost of the health care law for the 2015-24 period by $104 billion.

Looking at those one-year results, it’s hard to see Tillis’ “nightmare for millions of Americans.” Indeed, a much stronger video than the “you can keep it” creation would be a selection of testimonials from people who got insurance for the first time, or who got better insurance, or who didn’t lose insurance because they got sick or developed a pre-exisiting condition.

What is becoming clear a year after the start of the ACA is that its opponents’ understanding of its problems was as weak as their own health care proposals were empty. Consider the doom-saying that was coming from Senate Republican leader Mitch McConnell on the eve of the ACA’s launch. Writing in USA Today in July 2013, he said, “Nearly every day seems to bring more news of another state projecting massive insurance premium increases, or of another insurance company pulling out of the market entirely, forcing Americans off plans they like and want to keep.”

A year later, premium increases have slowed. More insurance companies are participating. And many people who lost lousy plans with high deductibles got better coverage for less.

In the same piece, McConnell said that “Obamacare” would keep businesses from expanding and that some would be forced to cut workers. On Friday, the Bureau of Labor Statistics announced that employers added 248,000 jobs in September and that the unemployment rate had fallen to 5.9 percent, the lowest level in six years.

Of course, the ACA has had its glitches, and it needs fixes. But overall it has helped millions of people and has helped control health care costs that were threatening to swamp the economy. It has also been one positive step toward addressing the growing problem of income inequality. It has given many people the financial peace of mind of knowing that an illness or an accident won’t leave them financially devastated and unable to afford care.

The president wishes he had chosen better language than the “you can keep it” line. His point was true for all but a very small percentage of Americans who stay permanently in the individual insurance market and prefer high-deductible plans, but it still wasn’t 100 percent true. On the other hand, Republican fear-mongering about families experiencing insurance “nightmares” and the ACA leading to exploding costs and lost jobs now appear to be almost entirely false.

Despite all that, public opinion remains polarized about “Obamacare.” That speaks to success of Republican politicians and conservative media in distorting the effects of the law and tying opinions on the law to opinions on the president. After a few more anniversaries, that linkage will weaken, and the value of Obama’s signature accomplishment will stand on its own.