# Is Obamacare a Success? **URL:** \ **Category:** Great Debates\ **Created:** [August 26, 2014, 8:51pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587 "2014-08-26T20:51:48Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 27, 2014, 4:51pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/41 "2014-08-27T16:51:51Z")
If it can’t happen to you, why would you insure against it? Should I buy homeowners’ insurance if I don’t own a home? ---
**Author:** ![slash2k](https://avatars.discourse-cdn.com/v4/letter/s/439d5e/32.png) [@slash2k](https://boards.straightdope.com/u/slash2k)\ **Post date:** [August 27, 2014, 5:10pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/42 "2014-08-27T17:10:22Z")
> [@adaher](#): > > If it can’t happen to you, why would you insure against it? Should I buy homeowners’ insurance if I don’t own a home? My homeowners policy includes (admitedly limited) coverage for furs. I don’t own furs, I won’t own furs, and I can’t buy a policy that provides no coverage at all for furs, because that’s just part of the standard package sold in my state. I think that’s a better analogy for maternity coverage as part of a standard package. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 27, 2014, 5:19pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/43 "2014-08-27T17:19:33Z")
But it’s not illegal to buy a policy that doesn’t insure furs. ---
**Author:** ![slash2k](https://avatars.discourse-cdn.com/v4/letter/s/439d5e/32.png) [@slash2k](https://boards.straightdope.com/u/slash2k)\ **Post date:** [August 27, 2014, 5:33pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/44 "2014-08-27T17:33:24Z")
> [@adaher](#): > > But it’s not illegal to buy a policy that doesn’t insure furs. No, you are correct that it’s not illegal. It’s impossible in my state (and in most states), but it’s not illegal. I’ve never seen a homeowners insurance company that is willing to write a policy that specifically refuses to cover a household item of the homeowner’s choosing. Have you ever seen one? (I’m not talking about policies that limit coverage to some low dollar amount, but policies that will exclude an ordinarily-covered item and give the homeowner a discount for not covering some household item that particular homeowner doesn’t own.) ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [August 27, 2014, 5:42pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/45 "2014-08-27T17:42:28Z")
> [@even\_sven](#): > > I believe a system where you only pay for things you use is called “not having health insurance.” A system where you pay for things that you _might_ use is what’s called “having health insurance”. A system where you are forced to pay for things that you can’t conceivably use is called “income redistribution”. ---
**Author:** ![Sinaptics](https://avatars.discourse-cdn.com/v4/letter/s/278dde/32.png) [@Sinaptics](https://boards.straightdope.com/u/Sinaptics)\ **Post date:** [August 27, 2014, 5:51pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/46 "2014-08-27T17:51:22Z")
> [@Fotheringay-Phipps](#): > > A system where you pay for things that you _might_ use is what’s called “having health insurance”. > > A system where you are forced to pay for things that you can’t conceivably use is called “income redistribution”. Even though it may not directly benefit you, it most likely does benefit you indirectly to not have pregnant mothers going without health insurance as they would be receiving completely subsidized coverage in the emergency room. Additionally, there may be additional critical care needed due to them not getting regular checkups. Further, I’m sure that mothers going without maternity care have an increased chance of having babies with disabilities thus creating an even larger burden on society. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [August 27, 2014, 5:53pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/47 "2014-08-27T17:53:29Z")
You’re saying it might not be insurance but that it’s a positive in other ways. That’s beyond the scope of the specific point that I was responding to. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 27, 2014, 6:05pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/48 "2014-08-27T18:05:36Z")
And the issue isn’t whether pregnant women get care, you can easily do that without making single men and older women pay for it. It would just cost a little more. Not even a lot more. ---
**Author:** ![LibrarySpy](https://avatars.discourse-cdn.com/v4/letter/l/f9ae1b/32.png) [@LibrarySpy](https://boards.straightdope.com/u/LibrarySpy)\ **Post date:** [August 27, 2014, 6:17pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/49 "2014-08-27T18:17:44Z")
The issue isn’t whether women get maternity coverage, it’s that they get free birth control, which lowers pregnancy rates and saves a lot of money on maternity care overall. Besides, the cost of maternity care with Cesarean (including prenatal to 3 months old) [PDF](http://transform.childbirthconnection.org/wp-content/uploads/2013/01/Cost-of-Having-a-Baby1.pdf) - $19,063 Annual cost of cancer care - [A LOT MORE](http://costprojections.cancer.gov/annual.costs.html) Who’s paying for who? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 27, 2014, 6:30pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/50 "2014-08-27T18:30:32Z")
That’s an interesting claim. Has the availability of birth control reduced the rate of unintended pregnancies? It does not appear to be the case: Following a considerable decline from 59 unintended pregnancies per 1,000 women aged 15–44 in 1981 to 49 per 1,000 in 1994, the overall U.S. unintended pregnancy rate has increased slightly to 54 per 1,000 in 2008.[6] > **[Unintended Pregnancy in the United States](https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states)** > > On average, U.S. women want to have two children. To accomplish that goal, a woman will spend close to three years pregnant, postpartum or attempting to become pregnant, and about three decades—more than three-quarters of her reproductive life—trying... ---
**Author:** ![Enginerd](https://avatars.discourse-cdn.com/v4/letter/e/bcef8e/32.png) [@Enginerd](https://boards.straightdope.com/u/Enginerd)\ **Post date:** [August 27, 2014, 6:35pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/51 "2014-08-27T18:35:24Z")
Are you using changes in the rate of unintended pregnancies between 1994 and 2008 to try to show the ineffectiveness of a law passed in 2010? I don’t think that’ll work. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 27, 2014, 6:37pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/52 "2014-08-27T18:37:33Z")
No, just trying to show that availability of birth control isn’t clearly reducing the unintended pregnancy rate. ---
**Author:** ![Enginerd](https://avatars.discourse-cdn.com/v4/letter/e/bcef8e/32.png) [@Enginerd](https://boards.straightdope.com/u/Enginerd)\ **Post date:** [August 27, 2014, 6:41pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/53 "2014-08-27T18:41:31Z")
You only presented half the argument. How did the availability of birth control change over the same time period? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [August 27, 2014, 6:47pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/54 "2014-08-27T18:47:36Z")
It got better. More and more options. Now it’s possible that “free” will cause women to be more diligent in the use of birth control than they are now, but I doubt it will make much difference. Free birth control was always more about politics than policy. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [August 27, 2014, 7:05pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/55 "2014-08-27T19:05:31Z")
> [@adaher](#): > > It got better. More and more options. Now it’s possible that “free” will cause women to be more diligent in the use of birth control than they are now, but I doubt it will make much difference. Free birth control was always more about politics than policy. “More and more options” is nonsense. The party you support, the GOP, has reduced access wherever it could by, for instance, closing abortion clinics. It also has been promulgating a nonsense strategy like abstinence only education. Couple that with slashing the safety net, you get a situation where people need to prioritize birth control with electricity. The GOP is taking actions that increase the birth-rate and as a result human misery. ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [August 27, 2014, 7:40pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/56 "2014-08-27T19:40:43Z")
> [@Fotheringay-Phipps](#): > > A system where you pay for things that you _might_ use is what’s called “having health insurance”. > > A system where you are forced to pay for things that you can’t conceivably use is called “income redistribution”. The problem is that if you combine 1. not having to buy a plan that includes pregnancy benefits with 1. Not using pregnancy as a pre-existing condition to exclude entry into a plan. Then 1. The only people who would opt into such a plan are those who are pregnant. Which means 1. In order to cover costs the price of such a plan would have to equal the cost of a pregnancy. which means 1. There is no benefit to joining such a plan. which means 6)Effectively no plans cover pregnancy. If you extend this to enough categories then there will be no insurance period. If those who don’t have Spina Bifeda, Autism, or CMT elect to not to buy insurance that covers these conditions. The price of insurance that does cover these conditions would be unaffordable to anyone, and so none of these people would be able to get treatment. Same with everything from cancer to high blood pressure. So you basically have two choices, either force people to buy coverage for things they won’t need, or decide that no one who knows they will need insurance can get it. The entire structure of Obamacare was moving from option two to the more compassionate option one. As long as those with pre-existing conditions can get healthcare not tied to their employment, Obamacare has succeeded. ---
**Author:** ![common\_good](https://avatars.discourse-cdn.com/v4/letter/c/f475e1/32.png) [@common\_good](https://boards.straightdope.com/u/common_good)\ **Post date:** [August 27, 2014, 8:12pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/57 "2014-08-27T20:12:23Z")
Yes. He is the best president since FDR. Posterity will regard his as one of the of best. And he’s done it with the most irresponsibly stubborn House of Reps. in American history. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [August 27, 2014, 8:42pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/58 "2014-08-27T20:42:59Z")
Yeah, we’ve been discussing this exact issue - under various iterations, mind you - for more than a year in my [Elections thread.](http://boards.straightdope.com/sdmb/showthread.php?t=679347) It’s an ongoing topic, so by all means look over there if you’re pining for a bit more nuanced ACA talk. Is Obamacare a success? Objectively, yes; it has dramatically reduced the rate of uninsurance across the country writ large, with some states that embraced the law - such as my own home state of CA - experiencing truly staggering declines in the uninsured population. At this point, I think the gauge of ACA success can be boiled down to two fundamental questions: 1. To what extent is the ACA **currently** successful? & 1. How successful will the law **eventually** be in the long term? The answer to **(1)** can be objectively divined just by looking at the plummeting national uninsurance rate. Unfortunately, talking heads rarely ever get that far because the ACA is seldom seen outside of a partisan lens, and no amount of objective, demonstrable successes can ever persuade supposed GOP policy wonks - I’m thinking specifically about hacks like Avik Roy here, but the entire Republican party essentially falls under this umbrella - that Ocare is a workable, sustainable, & _successful_ law that will eventually result in de facto universal health care in this country. The answer to **(2)** is going to take ages to resolve, however. Indeed, a number of things need to happen before it can ever be addressed: (1) First and foremost, the GOP needs to declare a fait accompli & stop its repeal crusade. These ongoing pledges to dismantle the entire law add unneeded barriers to its final goals, and those are compounded even more as soon as you get beyond the “repeal Obamacare!” nonsense & start examining all the ridiculous equivocations that 'Pub politicians make about ACA benefits & beneficiaries. (2) All the anti-ACA court cases need to cease & desist. Perhaps they finally will when we get beyond this Halbig bullshit, but until then ACA litigation in court remains another spiteful & desperate partisan barrier to its eventual success. And finally - (3) Medicaid expansion needs to happen in every state. We can thank SCOTUS for opening this can of worms back in 2012, but until this expansion is universal across the country the law will never be able to realize its full potential. And Gawddamnit, I’m thrilled to see **adaher** blatantly admitting that the ACA is successful, even if it’s followed with all of his usual Republican talking points and caveats. It’s about time! ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [August 27, 2014, 9:20pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/59 "2014-08-27T21:20:37Z")
> [@adaher](#): > > And the issue isn’t whether pregnant women get care, you can easily do that without making single men and older women pay for it. It would just cost a little more. Not even a lot more. So, single men can’t cause pregnancies? Interesting. Given that we old people are going to be getting more out of insurance than young people, even young pregnant ones, I think we shouldn’t be complaining. Statistically, everything is more efficient if we don’t break premiums down into hundreds of categories which change with time. What do you think the error rate would be for such a system? How many absurdities would be introduced? Not to mention **dangerosa** ’s excellent point about how each of us have benefited from maternity coverage. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [August 27, 2014, 9:22pm UTC](https://boards.straightdope.com/t/is-obamacare-a-success/696587/60 "2014-08-27T21:22:49Z")
> [@2ManyTacos](#): > > (3) Medicaid expansion needs to happen in every state. We can thank SCOTUS for opening this can of worms back in 2012, but until this expansion is universal across the country the law will never be able to realize its full potential. To look on the bright side, the experiment created by the red state governors makes it impossible for ACA opponents to claim that the reduction in the number of uninsured would have happened anyway or was caused by the phases of the moon or something. [Previous page](https://boards.straightdope.com/t/is-obamacare-a-success/696587.md?page=2) [Next page](https://boards.straightdope.com/t/is-obamacare-a-success/696587.md?page=4)