May 25, 2018
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Obamacare is working. So why repeal it?

Arminda Murillo, 54, reads a leaflet at a health insurance enrollment event in Cudahy, California March 27, 2014.

Those running for office this year and counting on an anti-Obamacare message to propel them to victory are encountering a pitfall they likely didn’t expect last fall as the health care reform law’s online insurance exchange got off to an inept start.

That “pitfall” is the law’s success, which is undermining many of the talking points the law’s Republican opponents have relied on for months to create the narrative that there’s no way the Affordable Care Act can succeed.

Except that it is succeeding and working largely as planned.

A year ago, the Congressional Budget Office projected that 7 million Americans would enroll in health insurance plans offered through the law’s online insurance exchanges. In spite of predictions that few would enroll, more than 8 million signed up during the fall and winter open enrollment period. In Maine, more than 44,000 signed up for a plan offered on the insurance exchange; the federal government’s goal for Maine was 23,000.

On top of surpassing enrollment projections, those who have enrolled are paying their premiums — about 90 percent have made their first payments — undermining yet another cynical Republican talking point about the law and those benefiting it.

The makeup of enrollees appears to be a relatively balanced mix of young and old, meaning there are young, likely healthy enrollees to balance out the older, potentially sicker adults in the risk pool. And more than half of those now enrolled in an exchange-offered plan did not previously have health insurance. A Kaiser Family Foundation survey released last month estimates 57 percent were previously uninsured.

As more have secured insurance through the exchanges — through Medicaid (in states that, unlike Maine, expanded eligibility), through the provision allowing young people to remain on their parents’ insurance until they turn 26, and through their employers — the United States’ uninsured rate has dropped to its lowest level since 2008. A Gallup survey in early June pegged the rate at 13.4 percent, compared with 17.1 percent in the last quarter of 2013, before Obamacare’s major insurance provisions kicked in.

To top everything off, the premiums new enrollees are paying aren’t busting their budgets. In Maine, exchange enrollees are paying $99 a month on average after tax credits are figured in, compared with an $82 average in most other states. In 2010 — before the Affordable Care Act’s insurance provisions and minimum requirements for health plans took effect — Maine residents buying insurance in the individual market paid $282 on average; the national average was $215 per month, according to the Kaiser Family Foundation.

Of course, many still make the philosophical argument that the government should not be controlling health care, which constitutes a sixth of the national economy. Some argue, then, that Obamacare should be repealed and replaced with a vaguely defined free market system in which competition among private insurers keeps prices in check.

To those who make such an argument: Obamacare is your private market system in which competition reigns.

As the open enrollment period for 2015 approaches, more insurers — large and small — are entering the marketplace and expanding their footprints to offer plans and vie for business. In Maine, the exchange will add plans from Harvard Pilgrim Health Care, joining existing plans from the non-profit Maine Community Health Options and Anthem.

Government’s role? Ascertain the products meet a certain quality threshold, ensure consumers can afford coverage and guarantee consumers the specific protections they’re granted under the law.

The Affordable Care Act has not played out perfectly, and public opinion still has not shifted decisively in its favor (likely because many of those benefiting from it — and satisfaction among that crowd is higharen’t crediting Obamacare). But any imperfection — technological malfunctions, botched contracting and difficulty in verifying insurance enrollees’ income — falls far short of dooming a needed law to failure. And the law’s growing list of successes go a long way to undermine opponents’ dwindling repository of anti-Obamacare talking points.


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