4 New Studies Show Obamacare Is Working Incredibly Well
A week ago, Sen. Charles Schumer said his party made a political mistake by passing the Affordable Care Act rather than some unspecified economic measure. Put aside the dubious political logic (in reality, Congresss appetite for additional stimulus had been completely exhausted with the passage of the original version). Also put aside the brutally cold moral logic (that politicians should prioritize keeping power over enacting positive change).
Schumers comments, announced at the National Press Club, sanctify a hardened perception among the general public, which has encroached into the Democratic Party itself, that Obamacare was not worth the trouble. The law is a bugaboo upon which every criticism of Obama has attached itself he is too economically elitist , or too partisan , or too complex . Left-of-center analyst Thomas Edsall recently went so far as to suggest Obamacare was destroying the Democratic Party. What makes this wave of regret not even taking into account the unmitigated hostility from the political right so strange is that Obamacare is actually working. Indeed, evidence continues to mount that the law is working extremely, even shockingly, well.
The overall goal of the law was to gradually reverse the two most perverse facts about the U.S. health-care system: Its overall cost has exploded, and it denies access to tens of millions of people. Four major new sources of information have come out this week, all of which have further demonstrated the laws success.
1. Increasing access to the uninsured. The law was never going to ensure that every single American had insurance. President Obama promised, in the face of political pressure, not to extend its coverage to non-citizens, who make up about one fifth of the uninsured population. Five * Supreme Court Justices decided to allow states to boycott the laws Medicaid expansion, adding some 4 million more to the ranks of the uninsured. Also, any new law takes years to ramp up participation and public awareness.
Conservatives widely denied that the law would even succeed at its basic goal of increasing access to health insurance. Obamacare created more uninsured people than it gave insurance to. And it promises to create even more, argued National Reviews Jonah Goldberg . Fox News panelist Charles Krauthammer proclaimed the law would result in essentially the same number of uninsured.
Every serious method of measuring has shown the law effecting significant reductions in the uninsured rate. The latest, a report by the Urban Institute yesterday, shows that the uninsured rate has fallen nationally by 30 percent:
That rate is 36 percent in states participating in the Medicaid expansion. The states whose Republican governors or legislators have boycotted the expansion have seen their uninsured rates fall by just 24 percent, dragging down the average.
2. Reducing overall health-care costs. Obamacare actually had two different fiscal responsibility goals. The first was simply to offset the cost of new coverage with a combination of spending cuts and higher taxes which, according to the Congressional Budget Office , it did. The second, more ambitious goal was to change the incentives that made doctors and hospitals eager to charge more money regardless of its effect, and that gave people who pay for that insurance little means to shop for better deals. Obamacares architects hoped that, on top of merely paying for the cost of new coverage, they could bend the cost curve downward.
When the law passed, conservatives insisted it would increase rather than decrease health-insurance costs. (Esteemed conservative intellectual Yuval Levin , in 2010, insisted it completely fails to reduce overall health-care spending.) Since the law passed, health-care inflation has fallen to historically low levels. Conservatives have repeatedly insisted this was a blip that would soon be reversed, and seized upon any apparent evidence for this case. When health-care spending spiked in the first quarter of 2014, Megan McArdle announced vindication: After all the speculation that Obamacare might be bending the cost curve, we now know that so far, it isnt. (It turned out the first-quarter spike in health-care spending was a preliminary miscount that has since been corrected.)
Also yesterday, the Centers for Medicare and Medicaid reported that health inflation in 2013 not only remained in, it fell to the lowest level since the federal government began keeping track:
3. Hospital errors. Obamacare has a wide variety of reforms designed to bend the cost curve. One of them is a new payment system that encourages hospitals to avoid readmissions. The old Medicare system reimbursed hospitals for every procedure. This meant they had a perverse incentive to do a bad job taking care of their patients a patient who developed an infection, or needed readmission, would produce a second stream of revenue for the hospital. Obamcares payment reforms changed that incentive. A new report finds that hospital-acquired medical conditions has fallen by 17 percent since 2010. (This has not only saved huge amounts of money, it has also saved 50,000 lives.)
4. Insurance competition. Obamacare is based on an old Republican plan, developed by the Heritage Foundation and first tried by Mitt Romney, whose central feature was market competition. The animating premise was that forcing insurance companies to lure customers on an open, regulated marketplace would bring prices down.
In all fairness, liberals did not place much faith in this dynamic. They didnt accept a health-care plan that gave insurance companies a central role out of ideological conviction, but out of necessity appeasing the industry, they calculated, offered them the only viable way to pass a bill through Congress. But the dynamic has turned out to work much better than expected. (The most natural ideological allies of the market function, conservatives, all committed themselves to the Republican Partys totalistic opposition to every facet of the law.)
A new Kaiser Health News analysis released this week finds:
A surge in health insurer competition appears to be helping restrain premium increases in hundreds of counties next year, with prices dropping in many places where newcomers are offering the least expensive plans In counties that are adding at least one insurer next year, premiums for the least expensive silver plan are rising 1 percent on average. Where the number of insurers is not changing, premiums are growing 7 percent on average.
The downside is that the lower prices require consumers to actively shop on the exchanges. Customers who automatically renew their existing plan without comparison shopping will miss out.
Obamacares bitter opponents on the right have increasingly trained their focus on measures of public opinion. It is true: Polling on the health-care law remains dismal as ever despite its success. Obamacares opponents have won a public-relations struggle. They have not won an argument.
*Edit: Seven justices actually voted for the ruling, which gave states the right to opt-out of Medicaid. Many legal observers believe, but of course cannot prove, that the support of two Democratic appointees for this measure was a form of horse-trading to preserve the law's overall framework, which John Roberts nearly decided to overturn completely. The actual decision to make Medicaid voluntary was likely made by five Republican-appointed justices, but formally the decision was endorsed by seven.
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by Johnathan Chait, New York Magazine: 4 New Studies Show Obamacare Is Working Incredibly Well
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Red Rules
- Be polite. No insults, about people or about ideas... or anything else!
- Stay on the topic of the original article.
- Explain your own thinking. Ask about others' thinking. DO NOT try to explain others' thinking!
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The topic here is the disconnect between reality -- the economic and social success of Obamacare -- and popular / political perceptions.
The reality of Obamacare's success is NOT to be questioned, unless newer and more credible data is supplied.
The success of the program should be very heartening for the hospitals and insurance companies, since the excess of cost has now been shifted to those who earn more than $45,000 per year.
At under $45,000 in salary, ACA is free. From $45,001 to $90,000 you pay, but the cost isn't terribly high, at least at first. After one year, my son received a 15% increase, with no bump to benefit.
My plan with Humana is still bumping me at high single to low double-digits per year, even though they must be "compliant". The compliance involves me paying for those who do not, rather than the insurance companies sacrificing a few cents in earnings (or decreasing their bloat), or the government.
I suppose it was going to cost me, one way or another.
Robert,
I specifically said that questioning the reality of Obamacare's success is off-topic, unless you bring "more credible data".
Here, you have done precisely the opposite. You describe something, but give no data at all to back up your claims.
Now... To try to get back on topic... Why are you convinced of the things you have just said, when the data says the contrary?
Feronia,
You cite two cases -- yours and your doctor friend's. I don't doubt them for a moment. But they are swamped by the Law of Large Numbers.
It would indeed be nice if every reform improved every aspect of every person's life... but... paradise is not for now...
A nation cannot decide policy on particular cases, not even if they are yours!
Policy must be decided "on average"... and the numbers are clear: more people are getting better deals.
Perhaps you should take a second look at your provider?
Johnathan,
Let's be lucid.
There were some forty or fifty million uninsured before Obamacare. They were not, for the most part, millionaires. Millionaires tend to have pretty good insurance.
There were a few "invincible" young people... but mainly... there were the poor .
I hope you have seen life expectancy statistics in America -- in particular the very close correlation between wealth and life expectancy. Poor Americans die MUCH younger than rich Americans. One of the objectives of Obamacare was to enroll more people. More POOR people.
The very wealthy get hit hardest, to pay for the system, then the kinda wealthy... and so on down to the poor themselves, who get subsidies. Obamacare is a massive redistribution program .
Every universal health-care system in the world is a massive redistribution program, for the very simple reason that health-care costs too much for the poor to be able to pay! Either a nation lets its poor die , or it subsidizes their health-care.
If you think this has anything to do with the intense opposition the right has put up against Obamacare... that is because you have a nasty, suspicious mind...
So... there may be particular cases, but... if Obamacare is costing you more the average... you are earning more than the average...
I am in the French health insurance system (Thank God!!!!). For almost all my professional life, I have paid more than most people. Because I earned more than most people!
Ah, socialism...
You may hold any opinion you wish... including that the Earth is flat.
The data says that the overall cost of health-care, whether expressed in lump sum or percent of GDP, is rising much slower than it was before Obamacare.
Here's the thing... Before Obamacare, costs were rising at X% per year. Since Obamacare, costs are rising at 1/2 X% per year. BIG improvement!! But if you only start measuring at the instant when Obamacare began, you will say, "Hey, costs are going up!"
The cost of health insurance was rising at a crazy, totally unsustainable rate. It has calmed to a supportable rate. It is still rising.
The world is not perfect...
Because I earned more than most people! That's easy to do in a country where the average income is so much lower than here in the USA.
A very human talent!
I am with you Feronia,
My insurance premium doubled in 2014, and I just received my renewal notice, and it has gone up another 62%. The deductible, and out of pocket went through the roof. I can not find a plan that is any better.
I do not protest the increases because I don't want the poor to get healthcare. I protest at the pass that the WEALTHIEST party got. That would be the insurance companies. Their profits are at records, and their profitability gains were uninterrupted by the ACA.
That is the source of my angst.
Insurance company profitspaid for not by the wealthiest, but by the Middle Class. Ya know, the Middle Class, the ones who truly drive America's economic engine, the ones who also footed the bill to bail out banks and insurance companies (hhmmm)a few years ago, and the oneswho will soon beincapable of paying anymore damned bills!
How could his post be any more on topic? He explained why Obamacare is so unpopular despite the "reality" of its so called "sucesss." Isn't that the exact point of the article?
Here's what has been happening over the last decades:
Steady increases, much faster than other stuff.
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I couldn't find an easy graphic for costs since the ACA went into effect. I found this headline, Healthcare spending in the US grows at slowest rate since 1960 , with this key information, " U.S. healthcare spending grew 3.6 percent in 2013, the slowest rate on record since 1960, federal health officials reported Wednesday."
There are two cases: If your revenues are WAY more than the average... then you will pay more than before. Obamacare is a wealth-redistribution system. It MUST be, if the poor are to be covered.
America's life expectancy statistics are shameful. The poor die MUCH younger than the rich. Those tens of millions of uninsured were primarily people who could not afford insurance. They now get subsidies so that they can get insurance and perhaps not die as young as their folks...
Those subsidies don't fall from heaven. The wealthy pay for them. Hey! The GOP's rabid opposition to Obamacare has a motive! The rich don't care if the poor die... but they DO care about their money!
If you don't make more than the average... then something is wrong. Your plan should not be rising that fast. Go talk to someone competent.
The ACA was a mega political deal. Lots and lots of horse-trading. If the insurance companies -- and their army of lobbyists -- had opposed the bill, it would have failed. So they got their pound of flesh...
It's an imperfect world...
But you're right. Big Business ALWAYS wins...
Red Rules. If I had wanted a deletion, it would already be done. I chose not to delete, because I thought there was a way to recover the situation.
If you are interested in a conversation on the topic I specified, then we can continue. If you want a different topic, you should start your own article.
Let me repeat:
No. He offered a different reality:
In case you didn't read the seed, let me summarize: Obamacare is a success. The skyrocket growth of health care costs which existed since the 1960s has slowed. Tens of millions of previously uninsured are now covered. No more "previous conditions". Kids are covered. Objectively, Obamacare is a success, as all the numbers show. ... But... People think it a failure.
Why does this disconnect exist? (Topic for this conversation.)
If people compare reality (Obamacare is a success) to promises (cost control, wider coverage, no "previous conditions", kids covered) they would have to be pleased. Promises kept! (Unless the American people is stupid, but I don't think Robert meant that.)
People are not pleased.
Therefore... We may conclude that they are NOT comparing reality to promises. Something else is going on.
What is going on?
That's the topic.
Ok, folks...
I didn't delete your personal complaints right off. Obviously, I should have, since that is all that is being posted now.
No more please. They will be deleted.
Thank you.
Your article 1st graph is incomplete . It lacks color code keys . Anything with actual labeled data can debunk something without proper explanation .
That's 100% false. Obamacare has obviously failed to live up to its promisess. Let's review the holy trinity of Obamacare promises:
1. Obamacare will result in savings of $2,500 per year per family of 4. (Completely FALSE)
2. If you like your plan, you can keep it (millions of plans were cancelled)
3. If you like your doctor, you can him/her (restricted access of Obamacare plans caused many to lose access to primary physicians.
So Obamacare failed to live up to its three promises to citizens. It also failed to insure anywhere near the amount of people originally projected by the CBO. We can also talk about the lost jobs and lost hours as employers have refused to hire full time workers to avoid penalties.
The reasons Obamacare has never been popular are plentiful. If you need any proof, look at all the democrats who have come forward in the last few weeks and admitted what a mistake it was.
I'ts great for insurance companies, for Americans not so much.
Robert,
The seed -- if you read it -- has a ton of data.
I specifically stated that that data was to be considered valid unless more credible data was produced.
You presented an "alternate reality" without any data at all.
Robert... If you don't like my rules... don't play. Just stay away! No one forced you to post here. If you want to invent stuff, fine! But not here! Post your own article.
Don't screw up mine.
Thank you.
In the future, I think I will add another Red Rule:
Sean,
You are supplying affirmations, with absolutely no supporting data.
Perhaps you aren't in the habit of using data, so let's take a look.
What data do you have to show that this promise was given, and that the American people consider that it was not kept and that that consideration is a major factor in their displeasure with Obamacare?
You think this is true... but do you have any supporting data?
Because there are at least two possible breadown points. First, was that promise made? If not, why do some people think it was? Second, why do they consider this significant, compared to things like "no previous conditions"?
There may be some interesting things to be said around this point, but without data we can do no better than " he said / she said".
Ok. There are surely interesting things to be said about this. Do most Americans know that the cancellations were either because the plan didn't meet minimum standards, or were decided by the health care provider, not the government? If the public doesn't know that, why don't they? And, again, do Americans really judge Obamacare on this, in preference to, say, controlling costs?
No data...
Same kind of questions as previously.
My point here is that your three critiques are conjecture. Without data, you say up, I say down... and there's no decision.
If so, then you should present better data. Without data, your post is just off-topic opinion.
I've been very light-handed about deleting off-topic posts in this conversation because I understand that people are not accustomed to either data or rules...
Bob this is going beyond ridiculous with these kinds of RBR restrictions. It is almost to an abusive level. That comment seems to be suggesting that opinions are unwelcome here. That's NOT what NTs is about or will ever be about . So lighten up a little and let a conversation evolve. There will never be a RBR enforced that prevents people from voicing their opinions on anyone's articles and that includes your articles too.."MiG"
Please understand that the objective is to dig into the subject, not just trade fact-free opinions.
The seed provides data. Until someone presents other data, the seed stands.
Off-topic
Off-topic
No. The 3.6% is a part of GDP. The spender is irrelevant, so that the figure is constantly comparable, before and after Obamacare. The slowdown is real.
As for the insurance companies winning... Yes. That was necessary to get their support for the ACA. Politics. Sad, but true.
The biggest winners, though, are the newly insured poor. Take a few minutes to Google life expectancy statistics. The (uninsured) poor die young, while the (insured) wealthy live lives that are long, as well as comfortable. The newly insured will be needing their insurance...
True. It's hard to ignore personal experience and embrace statistical "truth". Of course it's hard! It's our personal experience! It's real. It happened. Those statistics, on the other hand, are just cold numbers without flesh. They tell no human-interest stories...
But we're not doing human interest. We're talking aboutpolicy.Policy for 300 million people. It's kinda hard to collate 300 million stories.
"4 New Studies Show Obamacare Is Working Incredibly Well"
My Unionnegotiated health care cost have also risen, (manly because I keep getting older for some dam reason), but Nationally the cost of health care has grown at a slower rate than at any time since such records have been kept. Reality vs Perception
Mickey,
In the first Reply to the seed, I stipulated that
Please stay on-topic.
Thank you.
(I agree with what you're saying, but this is not the place to say it.)
ArkansasHermit,
In the first Reply to the seed, I stipulated that
Please stay on-topic.
Thank you.
(To avoid hassle, I allowed several personal histories to stand. The conversation quickly degenerated into a litany of personal histories. Please do not continue.)
I'm sorry, but this is not an answering service for questions about Obamacare. Please address such questions to... for example... Google...
Thank you
No.
No.
But since the answer is twice "no"... I repeat "not pertinent".
Do I get to decide what the topics of your seeds/articles are? I specified the topic for this seed very precisely.
I have the impression that many visitors did not read either the seed or my first reply. Did you?
This is drifting WAY off topic. Let's stop here.
---The topic here is the disconnect between reality -- the economic and social success of Obamacare -- and popular / political perceptions.---
Well, I think you would see the reason for this disconnect if you just let some of the people keep posting.
The people who think that it has been or is going to be a failure are either paying more for their insurance now with the increases racking up over the past couple of years (while being told it is because of the ACA [this is notnecessarilya completely true statement on the behalf of the insurance companies]), have been denied services (see aboveparentheticalreference), have had to change their insurancebecause the insurance that they had did not meet the minimum criteria of the ACA, etc.... In general, they have to pay more, for whatever reason, and thus they see the program as being a failure.
Or, you could say that the term success has variable definitions perceptually, so that what is a success for one person might not be deemed a success for another, because different people use different metrics to determine what success looks like.
I agree with everything you say... including the fact that I might have gotten this kind of answer if I had let things run. On the other hand... I would certainly have gotten even more torpedo posts.
The posts I got were basically, "My costs are rising, so Obamacare is bad!" They did not go back to the seed, which proved quite effectively that for most Americans the ACA has improved the economic situation. (I very much doubt that most visitors actually read the seed at all.)
If someone had posted, "My costs are rising, so I don't give a flying F about statistics. My perception of Obamacare is not, and never will be, what it does for the nation, statistically. If it doesn't make MY costs go down, it's bad! THERE is your disconnect!"... I would (I hope) have been delighted.
Exactly! That's EXACTLY right. The topic of discussion was not supposed to be Obamacare.
I never expressed any opinion, gunny. Never did... because that was not the topic.
I believe that there are parts of Obamacare that are very good, others, not so much.
Whether it's a success is in the eye of the beholder. Each defines success differently. If ACA helped me, I would think that it's a success. If it didn't, then I probably wouldn't think it was a success.
I do see a lot of complaining from both sides. That is to be expected. Personally I lived in a couple of countries that had ''socialized medicine''. I found it to be quite good. My kids and grandkids still live in these countries. So, for me, a single payer system is far superior to either the ACA or what we had before the ACA.
Did you read the seed, gunny? Or just the title? The subject of an article is in its text, not in its title.
No. This is not an opinion. This is a fact. The article gives a great deal of data proving that Obamacare is working. (Be careful here: I am not affirming that Obamacare works. The article does that. I am responding strictly to your Reply, "Evidently your opinion...")
I personally never gave any "opinion" at all on whether Obamacare is working.
I'm not sure I understand the usefulness of this question...
Dunno...
That's the problem with "drift". It's gradual. There's rarely a moment that one can point to and say "There!!"
Usually, it's when things have gone much to far that we wake up and ask ourselves, "Jeez... How did we get HERE??"
For once I agree with you.
Perhaps the explanation is that there is no relation to the national debate. There's no Red position and no Blue position.
For once, people are actually allowed to develop an opinion without having it dictated by anyone.
Refreshing, IMHO...
gunny,
The subject of the article is largely "the success of Obamacare"... but IMHO, the key section is
In other words, everyone -- including the Dems -- is running away from Obamacare... despite the FACT that it is accomplishing the principal missions set for it.
That an amazing situation, IMHO! The law is doing what it said it would: slowing cost increases and covering more people. The data is undeniable. Obamacare is accomplishing its missions! Period!
And yet... and yet... people don't like the law... That is also true.
That's an amazing disconnect, in my opinion. Obamacare is accomplishing the missions set for it, but people are not happy with it. How would a Marine feel if he accomplished his mission but the CC was not happy anyway?
Once again, gunny... I did not give MY opinion on anything. Nowhere. Not once. The article presented data , and no one presented countervailing data. (Believe me, you can do all the Google searches you want... Obamacare is indeed lowering overall healthcare costs, and covering millions more people. That is "reality"!)
But I did not want to argue "is Obamacare working?" That is not in doubt. YES, it is working. Period. The data says so. No one disputed the data.
We had several people present their personal cases. All told, maybe twenty cases. In a nation of THREE HUNDRED MILLION! Please!
I understand that if a person's rates go up, they are not happy. That is BESIDE THE POINT!
The topic that I set was: "Obamacare is working. People are not happy with Obamacare. Why the difference?"
Perhaps I wasn't directive enough??
Good point!
When discussing anything under the presumption that "it's working", we must know what the criteria are. What do we mean when we say "It's working"?
The seed is limpid:
That's clear to me, and I should think, for any Marine: Two objectives, bothachieved. Mission accomplished.
I'm sorry, gunny... but you are wrong. Read the seed again.
You, personally, may not see the cost going down... but the data are crystal clear: the costs are going down.
This is difficult. We all consider our personal experience to be representative of ... everything... But that isn't true. Each one of us is ONE among THREE HUNDRED MILLION...
It is very difficult to abandon one's own personal experience, and embrace astatisticalreality that doesn't "feel" right... but that's the real world...
You sent me an FR, Mickey.
I hoped that you would send me some specific questions... that we would create a dialogue...
Why not??
This conversation is dead, so no matter...
I really do not understand, Mickey.
I don't understand what you want. I don't understand ... you.
If you want to converse, I'm available.
The members of NT are a diverse group, and there are many conservative and libertarian members who view any program where government actively redistributes wealth as anathema. (Ignore for a moment that insurance does this very thing, albeit in a pay to play type of scheme.) So, in addition to the reasons I gave above, there are people right here who will never see the ACA or any other similar government program as a success because of the way it is supposed to work: People above a certain income level pay more and below a certain level get subsidized by the government. This fact raises some important questions pertaining to why they feel that way and what their specific perceptions are of the people whom this law is intended to help.
Oh...
Excuse me, then. Your FR came through in the middle of the Red Rules dustup, just when I had suggested that messaging would be a better way to discuss meta. I assumed that your FR was in that context.
So... please pardon me for being brusque.
I would be honored to be your friend in the sense that you describe. Feel free to contact me at any time on any subject.
Any time, any subject...