At 12, Obamacare has proven itself

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Former President Barack Obama’s joyous return to the White House marked an occasion many did not expect to see: the 12th anniversary of his landmark presidential achievement, the Affordable Care Act.

After all, public sentiment was mixed at best when the groundbreaking law guaranteeing health insurance coverage for Americans passed in 2010 without a single Republican vote. Then the GOP spent years trying to “repeal and replace” it, culminating in its failure during Donald Trump’s presidency to do neither.

Now, the measure hated by haters but now cheered by supporters like Obamacare is on the rise. It provides more than 14 million Americans with their health care coverage, and 38 states have used this provision to expand Medicaid to cover an additional 15 million low-income families. The part of the public that supports the system has reached its upper fifties.

“He did what he was supposed to do,” the former president said at a White House event on April 5. “It made a difference.”

Indeed, Obamacare coverage has been expanded by President Joe Biden, who rightly called the measure “big [expletive] agreement” on the day the former president signed it. Unfortunately, the work of the law is not yet finished.

Last year’s US bailout provision increasing the number of Americans receiving federal Obamacare grants by 2.7 million will expire at the end of 2022. An extension to 2025 was included in Biden’s Build Back Better Act which the Senate rejected earlier this year after narrowly clearing the House. Last year.

This means that unless Congress revives the BBB measure or includes an expansion in another must-have bill, according to Centers for Medicare and Medicaid Services estimates, 3 million Americans will lose insurance and 10 million others will face higher costs.

It could be another political problem for the beleaguered majority in the Democratic Congress — plus a blow to millions of Americans. This must not be allowed to happen.

Despite the partisan divisions that marked its birth, the law’s initial impact was enormous. The Centers for Disease Control estimates that the proportion of Americans without health insurance has fallen from 16% in 2010 to just under 9% six years later. That’s about where the census said in 2020.

In another measure of its success, the proportion of uninsured Americans in the 38 states that took advantage of the ACA’s provision covering most Medicaid expansion costs is about half that of the 12 states. who did not.

Two of the latter are Texas and Florida, where more than a million people are not eligible for Obamacare subsidies or Medicaid coverage.

In addition to expanding health care coverage, the ACA banned lifetime limits on insurance payments that had prevented some people with chronic conditions from purchasing needed coverage.

In a graphic example of the ideological divide between the two parties, the Obama and Biden administrations have repeatedly sought to expand coverage by subsidizing its costs.

In contrast, after failing to kill the ACA, the Trump administration sought to weaken it. The administration limited enforcement of the now-repealed requirement that everyone be covered and cut funds and time spent on registration and advertising.

Republican opposition to expanding health care coverage is not new. Most House Republicans voted to scrap key provisions of the original Social Security Act before supporting final passage in 1935. A majority of the House GOP voted to make Medicare voluntary before to also split upon final adoption in 1965.

Since taking office 15 months ago, the Biden administration has taken several steps to increase uptake and, therefore, reduce the number of uninsured Americans. In addition to increasing grants, he expanded the scope, extended the registration deadline and overturned several Trump rules that complicated the registration process.

As a result, registrations for Obamacare this year reached 14.2 million, up 20% year-on-year. Last week, the White House announced a plan to close one of the law’s remaining loopholes by allowing relatives of people with private insurance through their employers to qualify for Obamacare subsidies.

Still, some gains would be reversed if Congress fails to expand subsidies that help millions buy coverage.

Meanwhile, despite rising participation and declining rates of the uninsured, most of the conservative criticism continued — with some validity.

Two years ago, a report by the Heritage Foundation noted that the law had not only succeeded in reducing health care costs, but that they had increased. Citing statistics from the Department of Health and Human Services, the report states that “premiums have doubled for individual health insurance plans since 2013, the year before many Obamacare regulations and mandates took effect. “.

This, of course, is one of the reasons why Biden has increased the bonus subsidies and the number of people who qualify for them.

The GOP’s main target was Obama’s initial campaign promise that, under his plan, “if you like your health care, you can keep it.”

Independent fact-checking website PolitiFact initially said it was likely Obama’s claim would prove “too radical”. After revising his claim to say he meant “you can keep it if it hasn’t changed since the law was passed,” PolitiFact dismissed that claim, calling it “pants on fire,” which is his way of calling something wrong.

“It guaranteed the principle of universal health care,” Obama said at the White House. In reality, however, this principle has not yet been fully achieved since nearly 28 million Americans still do not have health insurance, including a quarter of children.

Nevertheless, the ACA has been a boon to millions of families who could not afford to insure themselves beforehand or were not entitled to purchase it.

Carl P. Leubsdorf is the former Washington bureau chief of the Dallas Morning News and a frequent contributor. E-mail: [email protected]

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