January 27, 2020


Obamacare's Secret Success: With little notice, the ACA has racked up a big win - near-universal coverage. (EZEKIEL EMANUEL, CATHY ZHANG and AARON GLICKMAN, 01/27/2020, Politico)

Under the Affordable Care Act, several states have already achieved near-universal coverage, and without anywhere near the national disruption that a full system reboot would cause. As of 2018, six states and Washington, D.C. have achieved over 95 percent health care coverage for their residents.

This coverage triumph does not mean that the American health care system does not need reform. But it does demonstrate that the ACA can catalyze near-universal coverage. And by adopting some modest policy reforms, every state, and the country as a whole, can get there, too.

This has happened despite the fact that the Trump administration has tried to sabotage health care expansion. The administration has cut the insurance exchange open enrollment period by 50 percent, reduced advertising and navigators to help people buy insurance by nearly 90 percent, added requirements to Medicaid to discourage enrollment, and authorized "skinny" insurance options with bare-bones coverage designed to lure healthy enrollees away from comprehensive plans in the ACA insurance pools.

The Census Bureau's American Community Survey, which calculates average national and state-level uninsured rates over the course of the year, reports that Trump has succeeded in increasing the number of uninsured. In 2013, just before the ACA exchanges and Medicaid expansion went into effect, the uninsured rate was 14.5 percent. It dropped to a low of 8.6 percent in 2016. Despite a booming economy and record low unemployment, the Trump administration increased the uninsured rate to 9 percent in 2018.

But the trend is not uniform across the country. Some Republican-controlled states have especially high uninsured rates. Texas has an uninsured rate of 17.7 percent, with a fifth of the nation's uninsured children. Georgia's uninsured rate is 13.7 percent, and Florida's is 13 percent. Together, just these three states account for roughly a third of all uninsured Americans.
Countering these failing states are Hawaii, Iowa, Massachusetts, Minnesota, Rhode Island, Vermont and D.C., which, using the tools provided in the ACA, have all achieved coverage rates over 95 percent and as high as 98 percent.

Posted by at January 27, 2020 12:00 AM