You can quibble about the approach, the cost and some of the basic tenets of the law, but a growing number of experts say the nation’s latest major healthcare policy is doing exactly what it was intended to do: increase insurance coverage in the United States.
Wednesday marks the sixth anniversary of the passage of the Affordable Care Act, and economists have market it by sharing evidence that suggests the dramatic gain in the number of Americans with coverage is due to the law – not the gradually recovering economy.
The ACA was signed into law March 23, 2010 and in the six years since, the share of Americans without health insurance has dropped to a historic low of about 9%, with room to fall even further. What’s more, it appears that this trend has been driven without reference to economic growth.
Healthcare experts point to several government surveys to back up this assertion. The Census Bureau’s America Community Survey, for example, found that about 3 million more people gained employer coverage between 2010 and 2014, but the number of uninsured people dropped by more than 10 million during the same period.
Another survey from the Centers for Disease Control and Prevention found that while employer coverage was basically flat during that period, more than 12.6 million people enrolled in health insurance plans.
“This kind of shift in insurance I don’t think can be explained by the economy,” Rand Corporation Economist Christine Eibner told the Boston Globe. “The increase [in coverage] is large enough that it can’t be driven by just economic recovery.”
Much of the growth does appear to be due to the expansion of Medicaid in several states, the Census Bureau survey notes.
Regardless of which tenets of the law are responsible, however, economist Robert Kaestner of the University of Illinois Chicago says it is difficult to argue the ACA has failed to deliver on its promise.
“It’s very clear that the Affordable Care Act has done most of the work in decreasing the number of uninsured,” Kaestner said.
And with that kind of result, many now believe that the law’s detractors may be out of options for repeal.
While the ACA remains highly unpopular in the Republican party, political pundits argue that taking away healthcare coverage from millions of people could hurt the party electorally if the eventual GOP presidential nominee is seen as having an implausible replacement plan.
“Repealing the law without a plausible plan for replacing it would be a mistake,” a policy paper from 10 leading Republican health experts said.
That appears to be the case – at least currently – with current Republican frontrunner Donald Trump. An analysis published last week from the nonpartisan Committee for a Responsible Federal Budget found that Trump’s outline of repealing and replacing the ACA would increase the number of uninsured by about 21 million while costing the government nearly $500 billion over 10 years.
And that just isn’t going to cut it, said economist Gail Wilensky.
“Any repeal has to have a way to increase coverage and not just by a few million,” said Wilensky, who ran Medicare under former President George H.W. Bush. “[The ACA] is obviously not the only way to do this – but it is important that it gets done.”
