Natalia Pollack, uninsured since 1999, is assisted to sign up for health insurance through the Affordable Care Act, by Carlos Tapia, a certified application councilor in New York City, March 31, 2014.
Mike Segar/Reuters

ACA ‘appears to be accomplishing its goal’

In one of the strangest columns on health care policy I’ve seen in a long while, Peggy Noonan on Friday characterized the Affordable Care Act as “a catastrophe like no other.” She insisted that if observers “step back and view the thing at a distance,” one “cannot look at ObamaCare and call it anything but a huge, historic mess. It is also utterly unique in the annals of American lawmaking and government administration.”
Such a sweeping condemnation was certainly in line with Beltway assumptions roughly five months ago. When was dysfunctional for a couple of months – remember when that seemed like a big deal? – Americans were told this was Obama’s Katrina, Obama’s Iraq, Obama’s Watergate, Obama’s Iran-Contra, and in one especially memorable analysis, Obama’s Bay of Pigs.
But given what we now know, if honest observers step back and view the thing at a distance, the ACA is working.
In the U.S., the uninsured rate dipped to 15.6% in the first quarter of 2014, a 1.5-percentage-point decline from the fourth quarter of 2013. The uninsured rate is now at the lowest level recorded since late 2008.
The uninsured rate has been falling since the fourth quarter of 2013, after hitting an all-time high of 18.0% in the third quarter – a sign that the Affordable Care Act, commonly referred to as “Obamacare,” appears to be accomplishing its goal of increasing the percentage of Americans with health insurance coverage.
The trick of surveys like these is that it’s tough to say with certainty exactly why the uninsured rate is falling so quickly. Some of this may be the result of an improving jobs landscape, with more Americans moving from unemployment (with no insurance) to full-time jobs (with coverage).
But given the available evidence, “Obamacare” certainly has something to do with the sharp improvement in covering the uninsured, Indeed, Jonathan Cohn looked at the new Gallup data alongside related reports from HHS, Health Reform Monitoring Survey, and the Rand Corporation, and concluded, “In short, it seems pretty clear that, because of Obamacare, more people have health insurance. And, yes, that accounts for people who lost existing coverage because insurers cancelled old policies.”
Consider a brief tale of the tape:
* ACA enrollment through exchanges reached 7.1 million, ahead of early estimates.
* If we include Medicaid, coverage has been extended to well over 10 million Americans.
* The ACA is quickly reducing the uninsured rate.
* According to the non-partisan Congressional Budget Office, the ACA is cheaper than expected and its risk-adjustment provisions are on track to turn a profit for taxpayers.
* Thanks in part to the ACA, health care spending has slowed dramatically and health care inflation is at its lowest point in 50 years.
* According to the Department of Commerce, the ACA is also having a positive effect on personal incomes.
Lazy partisans and ideologues can ignore all of this and cling desperately to the notion that the law is not only failing, but is also “a catastrophe like no other,” but they really shouldn’t bother. The evidence to the contrary is simply too overwhelming.