No, it has not been a scandalous disaster. First,it was introduced 9 years ago, not 5. Second, the exchanges have provided a chance for millions to become insured, and they have not had a death spiral/collapse. See the link for the uninsured rate movement since the exchanges fully activated. This represents people buying subsidized private insurance or medicaid. These were people who originally couldn’t afford or were too sick to get coverage. There were about 25 million of them, so for them, this has been a lifeline.
Design: As it was originally written, it was too weak. The subsidies weren’t strong enough, and the mandate was too weak. Like any big bill, there were unintended holes in the law that needed to be fixed. For it to do what was intended, there need to be improvements (big improvements). The Supreme Court ruling that made the Medicaid expansion optional for the states was a big blow, too, for millions.
To make improvements as mentioned in #1, it requires our congress to do a markup bill. But that won’t happen. It has been the subject of withering attacks from Republicans for a full decade, and they will never change on that point. Back then, I had figured they would eventually give in and try to be constructive to improve the law. I was wrong. They’ll never accept it, but they also don’t want to do anything to improve the situation either. The current president has done a number of things to try to destroy the exchanges. He’s cut off CSR payments. He’s stopped outreach funding. He’s stopped funding navigators. He’s trying to put work requirements on Medicaid recipients. He’s zeroed out the mandate penalty to make it a mandate in name-only. Many states don’t want to run their own exchange and try outreach, especially red states…which also won’t accept the Medicaid expansion, even though it’s a very good deal with the federal matching funding. Republicans are dug in against the ACA at the federal and state levels.
Given #2 above, the only way anything changes for the better currently is on a state-by-state basis. I live in a red state that wants to do absolutely nothing to help people. There are blue states that are starting to take matters into their own hands.
If Democrats ever get both houses of congress and the white house again (like 2009), they will likely to some version of Medicare for All. The politics has shifted, IMO, because of #2. The Republicans aren’t going to be constructive. So, I think Dems are saying “F it, we’ll just go M4A”…
The main problem is politics. The ACA has worked well, but needs to be fixed. However, politics won’t allow it…
I will be happy to introduce you to at least a dozen people whom I know personally, none of whom would have any health insurance at all were it not for the Affordable Care Act.
Not to one up you, but I know people who would be dead without the ACA. They had or developed conditions that insurance companies have spent years trying to avoid paying the bills for. Nobody was going to perform their treatment without health insurance.
ACA could have been a ton better, but it was better than nothing at all.
Not “scandalous,” but it’s far from “affordable.” Plenty of people are still paying sky-high, crippling insurance premiums for unsatisfactory coverage. We are decades overdue for single-payer.
It was a huge blunder of the D’s to not implement single-payer in 2009.
Yes plenty of people have care who would not have had before while substantially reducing the budget deficit from what it otherwise would have been. A pretty reasonable 2017 assessment of what it has and has not done - in the face of multiple attempts to kneecap it - here.
20 million covered who would not have otherwise been with added financial security, decreased inequality, and a decreased Federal deficit. Too soon to grade its impact on overall health but the focus is now better. Still though expensive and confusing.
Overall a very significant success despite GOP attempts to make it fail, and definite room to accomplish much more.
Well, the death panels still haven’t kicked in yet, so we’re going to have to wait and see how those turn out before we decide whether Obamacare failed.
I agree with a lot of what you say. But a fair % (not sure the exact number) who gained coverage via the ACA did with with Medicaid expansion, which has no co-pays/deductibles and usually little to no premiums. Just a point of info.
You’ve forgotten how tight the margin was in passing the ACA. Even that watered down half measure was within an inch of getting derailed by right-leaning dems, single payer in 2009 was flat out impossible. If Obama had spent his political capital tilting at that windmill, we’d have neither.
Wow. Wow! We have another forum here where impressions like yours can be addressed frankly.
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It was a huge blunder of the D's to not implement single-payer in 2009.
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Remember that Obamacare had Zero (with a Z) Republican votes (despite that it was largely a Republican program! :eek: ) In early 2009 the Democrats could not break a filibuster because Moscow Mitch refused to allow Al Franken to be seated. (Ted Kennedy, key advocate of healthcare, passed away just 7 weeks after Franken was finally sworn in.)
Because Every.Single non-Republican Senator was needed to override a Republican filibuster, ***Joe Lieberman, Senator from the State of Insurancecticut had complete veto power over every provision of the bill.*** Guess what was most important to him?
Normally, after versions of a bill pass both the Senate and House there is a conference to iron out differences and fix weaknesses. However this was impossible — by the time a conference might be scheduled there were 41 Republican Senators (including Ted Kennedy's replacement), ***all vowing to vote No no matter what!*** The only ACA that could possibly be enacted, therefore, was the version the Senate had passed in the earlier autumn.
FYI, that’s pretty much SOP for the US POW exchanges; we let go a LOT of their guys for a few of ours. It’s been that way for a long time- Bergdahl’s swap wasn’t remarkable or unique at all. (source- a friend of mine is a military history professor and writes books on this kind of thing, and gets interviewed on national news outlets for it)
As for the ACA… I think I’d call it a qualified success if you’re looking at it from the Democrat/liberal side. It’s not perfect, but it has got a lot of people insurance who wouldn’t have otherwise had it, and more importantly, it mandates that a lot of preventative care stuff is at no charge to the patient (https://www.healthcare.gov/coverage/preventive-care-benefits/).
That’s a game changer in a lot of ways, if people can get basic preventative care screenings and some treatment at no cost. People don’t have to make a choice between their annual physical or OB-Gyn appointments and making ends meet.
Obamacare had two objectives. 1. Expand coverage so fewer people went without insurance 2. Bend the cost curve so that healthcare spending would be cheaper. Both have failed.
The percentage of Americans without health insurance is 13.7% and when Obama was elected it was 14.6%. This is at a time of record low unemployment.
Premiums have been increasing at the samerate they were before Obamacare.
These failures are why Democrat candidates for president are running on Medicare for All, instead of Obamacare.
Yeah, because they blew it the first time, if you accept that they ever really wanted to do a better for the people. Just like Don’s promises of what he would do with healthcare. Silent on healthcare since his election even though he had both houses for 2 years.
“Running on” and delivering are very different things.
Could some of the negative reaction to Obamacare be attributed to the fact that - whatever his personal merits - Obama was an atrocious Chief Executive, passive and disengaged?
Well, whatever you think about the ACA, it’s gone much better than infrastructure week.
The words you are looking for are “shifty and uppity.” For example, “Yes, there are quite a few people who hate Obamacare for no other reason than a shifty and uppity President got credit for it.”