The Affordable Care Act turned the American healthcare system on its head when it became the law of the land in 2010. The question is: did it do so in a good or bad way? It depends on who you ask.
Now that five years have passed since it first became law, can we call the Affordable Care Act, commonly referred to as Obamacare, a success or a failure? As is often the case with political hot potatoes like this one, it depends on who you ask and the information they use to make their case.
For example, in recent months (and even years) a number of journalists, politicians, and "thought leaders" have declared Obamacare to be a disappointment at best and a miserable failure at worst.
Take John Goodman, a senior fellow at the Independent Institute. In an article he wrote for Forbes late last year, he said, "Obamacare is the American version of national health insurance. In Britain and Canada, for example, the primary goal was to remove money as a barrier to health care. How does Obamacare rate by that standard? Not very high."
Goodman based this particular piece of criticism on the fact that, "unless they were previously uninsured, people who are getting health insurance in the (Obamacare) exchanges are likely facing greater financial barriers to care than they were before the health reform was enacted."
He also criticized the Affordable Care Act for the non-financial barriers that he said have been placed between consumers and health care. Specifically, he pointed to "the narrow networks that have emerged in the insurance company race to the bottom. These networks often exclude the best doctors and the best hospitals."
Finally, Goodman suggested that "millions of Americans are being forced to switch to the wrong kind of insurance" because of this controversial law. "Many employees of fast food restaurants have mini med insurance, which covers the first few thousand dollars of care. These employees tend to be young and healthy and mini med plans pay for primary care--which is about the only care they are likely to need.
"The Obama administration considers that kind of insurance 'under insurance,' however, and the new law insists that people have coverage for catastrophic care, with no annual or life time limits," he added. "Yet this kind of 'comprehensive coverage' often has very high deductibles--forcing the young and the healthy to pay for primary care out of pocket."
Likewise, New York Senator Chuck Schumer ruffled more than a few of his fellow Democrat's feathers in late 2014 when he publically proclaimed Obamacare to be a mistake.
"Democrats blew the opportunity the American people gave them. We took their mandate and put all of our focus on the wrong problem--health care reform," he said while at the National Press Club. "The plight of uninsured Americans and the hardships caused by unfair insurance company practices certainly needed to be addressed. But it wasn’t the change we were hired to make; Americans were crying out for an end to the recession, for better wages and more jobs; not for changes in their health care."
Admittedly, Schumer didn't specifically say the Affordable Care Act has failed to perform as promised, but even so his comments suggest he's less than thrilled with how things have turned out for it so far.
Of course, it's easy enough to find people who think Obamacare is doing pretty well, too.
Unsurprisingly, for instance, the U.S. Department of Health and Human Services seems pleased with how the law is performing in its fifth year of existence.
"After years of dropped coverage, flimsy plans, and barriers to care, everyone’s coverage has improved, because consumers have new protections, including those who get health insurance through their employers," Sylvia Mathews Burwell, Health and Human Services secretary, said in a post published on the department's blog.
"They can’t be turned away because of pre-existing conditions [and] they can’t be dropped just because they get sick," she added. "Insurance has to cover care that Americans count on … like trips to the emergency room, prescriptions and preventive services."
Among the statistics the department has trumpeted in recent press releases devoted to various Affordable Care Act accomplishments:
Some state officials, such as Scott Kipper, commissioner of the Nevada Division of Insurance, also are touting the law's success. "The heightened awareness and availability of information to consumers is one of the great outcomes [of Obamacare] so far," says Kipper. Kipper also reports that the Affordable Care Act has helped drive down his state's uninsured rate from 20 percent to 11 percent.
Other sources also have thrown their weight behind the notion that the Affordable Care Act is working.
In an article about the law that was published in March, The Economist proclaimed that "Obamacare appears to be working better than expected. First … the proportion of Americans who lack cover has fallen from 16.2 percent to 12.3 percent since 2009. Second, the previously terrifying pace of medical inflation has slowed. The amount that America spends on health care grew by 3.9 percent a year in nominal terms between 2009 and 2011—having grown by 7.3 percent a year" between 2000 and 2008.
The New York Times' Paul Krugman has had similarly positive things to say about the law, and in a late-2014 column he described it as a policy that "continues to rack up remarkable (and largely unreported) successes." Later, in the same piece, he said, "if you think of Obamacare as a policy intended to improve American lives, it’s going really well."
As for the American public, they seem to be of both minds as to whether Obamacare is a success or a failure.
On the one hand, a poll conducted by the Kaiser Family Foundation in January found that when participants were asked to share their general opinion about the law, "unfavorable" outpolled "favorable" by 46 percent to 40 percent.
On the other hand, another recent poll (for United Technologies and National Journal) found that 63 percent of Americans believe Obamacare will "make things better" for people who do not have health insurance. But 59 percent think it will benefit those who are poor. (Just one-third of participants responded that it would "make things … worse" for those groups.)
Curiously, that same poll also determined that broad swaths of Americans—Caucasian ones, especially—are wary as to whether the Affordable Care Act will improve their lives or the lives of people like them. (49 percent said they thought it would make things worse for "people like you and your family," while 33 percent said it would make things better.)
One last result that's sure to be worth sharing revolves around nearly 60 percent of the Kaiser poll's respondents saying that the law hasn't impacted them personally. Still, more people indicated they had been hurt (25 percent) by Obamacare than helped by it (16 percent), which adds yet another wrinkle to this contentious topic.
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