Last week, the nation’s uninsured began their enrollment in the second year of the health reform law. The end of the first year offers the nation a good opportunity to review the impact of the law, without all of the reports of mistakes, the campaigns of deception and outright lies.
The Affordable Care Act, also known as “Obamacare,” was approved in 2010 and has been the subject of a sustained campaign of distortions and partisan attacks ever since. The law finally went into effect last year.
The goal of the law was to reduce the massive number of Americans without health insurance. At the time of passage, nearly 50 million Americans lacked health coverage. For those without health insurance, illness or injury can have catastrophic consequences. For example, uninsured patients are less likely to get recommended cancer screenings and are more likely to be diagnosed with cancer at later stages. Uninsured women diagnosed with breast cancer are 2.5 times more likely to have a late stage diagnosis than women enrolled in private health insurance. And lack of health insurance can have tragic financial impact as well: inability to pay medical bills is a leading cause of bankruptcy in America.
Thanks to the Affordable Care Act, the number of uninsured Americans fell dramatically in 2014. About 10 million more Americans now have insurance. The data shows that the biggest winners from the law include people between the ages of 18 and 34; blacks; Latinos; and people who live in rural areas.
But the data suggest that there have not been improvements in every state: uninsured rates fell in states that have expanded eligibility for their Medicaid programs (as allowed under the ACA) but did not significantly change in states that have not yet done so. Medicaid is the health insurance program for the poor.
Those states are primarily found in the South and Midwest and have state governments that have been hostile to the new law and, in many cases, have tried to impede its implementation. That political resistance could be a major factor in keeping uninsured Americans from getting coverage.
New York was one state that chose to participate in all aspects of the federal health care law. During its first year, New York's exchange enrolled nearly one million people. As a result, the state’s uninsurance rate has dropped from over 13% to 10% in the first year.
A big portion of that drop resulted from the enrollment of more people in the state’s Medicaid program. More than half of New York's first-year enrollees qualified for Medicaid based on their income. New York expects to sign up 350,000 new enrollees for 2015. The second year enrollment period started this past Saturday (November 15) and runs through February 15, 2015. (You can get information on the New York program at http://www.healthbenefitexchange.ny.gov/.)
Despite the deliberate efforts to undermine the program – and thus deprive millions of Americans health insurance coverage – the Affordable Care Act has achieved a lot.
That’s not to say that the program is perfect, or that it should be exempt from criticism. It can be strengthened and should be. Other models, such as Vermont which is seeking to create a state version of the Medicare program – a single insurer for all eligible citizens – should be considered as well.
But to orchestrate hysteria to achieve political ends – even if it means the health and, in some cases, the lives of Americans – is indefensible.
Ten million new insureds is a big first step, but it is only that. Tens of millions more still need insurance, probably a million of them in New York.
But there is no denying that a program designed to enroll millions of Americans is on its way toward achieving its goals. In an era of growing public cynicism and a toxic political environment, the nation should celebrate programs that help people in need.
The Affordable Care Act is one such program.
Blair Horner is the Legislative Director of the New York Public Interest Research Group.
The views expressed by commentators are solely those of the authors. They do not necessarily reflect the views of this station or its management.
