Even as the newly powerful Republican Party prepares to mount yet another attempt to repeal or at least damage what they like to call Obamacare, we have to ask: Is it even worth the fight at this stage?
The biggest news to come out of the Affordable Care Act (ACA) was the major fiasco involved in its initial launch when the website couldn’t handle the rush of people trying to sign up. Since then, news related to the ACA has been quiet. So much so it is hard even to say whether what some might argue was the biggest victory of the Obama administration, was even a victory at all. Sure we all know there are lots of people who did manage to sign up for the new federal health plan. But we also know the whole system is still shrouded in mystery and a sense of bureaucracy for millions of others. So which is it? Has the ACA been a success or a dud so far?
Certainly the biggest positive is that, according to estimates, about 9 million people gained health insurance over the last year. That is no small number to sneeze at. Nine million people who don’t put an additional strain on emergency rooms and increased health care costs due to having to ignore or wait on serious health concerns make a big difference in the burden on our healthcare system.
But it should also be noted that Kaiser Permanente estimates that 28 million Americans were eligible for the program, so that means about 19 million people either did not choose to bother with it or could not figure it out. According to estimates, of that huge number that still did not get coverage, the young, the lower income and the non-white are disproportionately represented.
So the determination as to whether the ACA is a success or not really has to turn on that last statistic. The whole point of the ACA, at least as I thought about the whole impetus behind it, was to help those who could not afford to otherwise get health insurance and who were in a sense a burden on the system and a danger to themselves because they were having to forego necessary and preventative healthcare. These are the people for whom the emergency room is the only time they see a doctor. And for the vast majority of them, those emergency room bills go unpaid, which of course raises the cost of healthcare for everyone else who does pay their hospital bills.
If the vast majority of the people not enrolling in the new healthcare system are those same people, low income, largely minority, people, then not a whole lot has changed with the ACA.
But it is also unfair to make a final judgement on Obamacare since a program of this size is not going to start perfectly nor is it finished working through the kinks. I suppose the ultimate measure of whether it is a success, so far at least, is not the number that did not enroll, but the number that did. Without Obamacare the uninsured number would be many millions higher. So any reduction has to be good. It is also true that those who have enrolled have indicated happiness with their care and happiness with the cost. Those were some of the publicized scares the Republicans threw out there about expected problems with the government system. That did not happen. The people using it are happy.
So, all in all, my vote is that the ACA has been a success. No system is perfect, even after many years of existence. The ACA has not been around long at all. With more education and more tweaks to the system, the numbers of those uninsured and still not yet enrolled will get better. And the fewer uninsured people there are, the much better off the entire country will be, as healthcare impacts so many areas of our lives from economy and worker productivity to education and missed school days, to taxes, you name it. It hasn’t been the smoothest start. But the start has definitely been in the right direction.
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