As supporters of the Affordable Care Act (ACA) celebrate its fifth anniversary, it is a good time to review the various arguments made by opponents of the ACA and see how they are holding up.
The opponents of the ACA said it would fail.
In fact, a report the Department of Health and Human Services released last week says that 16.4 million non-elderly adults have gained health insurance coverage since the ACA was signed five years ago on this day. This translates to the uninsured population dropping from 20.3 to 13.2 percent, or more than a third since 2012.
Looking more closely, the report shows that coverage has increased most rapidly among young adults, minorities, and low-income populations (in states that expanded Medicaid). An estimated 5.7 million young adults have gained coverage since 2010, due in part to the provision enabling them to stay on their parents’ plans until age 26. Additionally, since the start of open enrollment in October 2013, the uninsured rate among African Americans was cut almost in half, from 22.4 to 13.2 percent, and dropped almost a third for Latinos, from 41.8 to 29.5 percent.
In the 29 states that expanded Medicaid, uninsurance rates for those under 138 percent of the poverty line fell by 13 percent, compared to 7 percent for states that did not take up the expansion.
The opponents of the ACA said it was a job killer, and that it would cause employers to push more workers into part-time work to avoid employer mandates.
In fact, the economy has created 10 million jobs since the ACA was signed, and today’s 5.5 percent unemployment rate is the lowest in the past five years. And involuntary part-time work has actually fallen, not increased since its post-recession high point.
The opponents of the ACA said it was a government takeover of health care.
In fact, private insurance companies are the mainstay of the ACA. They are providing health coverage to millions of Americans through the Marketplaces, and competition among them is heating up. This past fall, the Obama Administration announced 77 new health insurers joined the Marketplaces, or a 25 percent increase in insurer participation over 2014. More insurance companies in the game means more competition and lower costs for policyholders.
The opponents of the ACA said the new law would explode the federal budget deficit.
In fact, the Congressional Budget Office (CBO) continues to estimate that overall the ACA reduces the federal deficit, and last week it issued a new report projecting that the total cost of providing coverage under the ACA will drop by almost a third, down from the original estimate of $710 billion to $506 billion over the next five years.
The opponents of ACA said employers would drop health coverage and dump employees into the Marketplaces.
In fact, there is no evidence of that is happening. An article in published by Forbes last week, entitled “Employers Warm to Obamacare, Stick with Coverage,” cites a survey by Mercer, a top employee benefits consultant, and concludes the following:
Five years after employers were considering terminating health coverage due to costs and other issues related to the Affordable Care Act, companies have largely changed their tune as fears have not been realized, according to a new analysis.
The opponents of the ACA claimed that under the new law, health care costs would continue to skyrocket.
In fact, the ACA has helped slow the escalation of health care costs, and helped make insurance more affordable. HHS has projected the following for 2015:
For customers returning to the Marketplace, the vast majority of enrollees have low cost plans available to them. If they look across all coverage levels, fully 79 percent of current Marketplace enrollees can get coverage for $100 or less, after any applicable tax credits, in 2015. [“Metal levels” refers to Bronze, Silver, Gold, and Platinum plans.]
The opponents of the ACA are now claiming the ACA insurance subsidies are only available in state-run Marketplaces.
In fact, the legislative history of the ACA clearly demonstrates that low-income policyholders in all states are eligible for insurance subsidies.