The Affordable Care Act seems complex to many in large part because it addresses several problems at once. "Obamacare" vastly expands consumer protections, improves efficiencies throughout the system, provides tax breaks to small businesses, reduces medical errors, and on and on.
But the principal point of the law has always been the same: bring health care coverage to those who don't have it. The United States has long been the only major democracy on the planet that allows its citizens to go without access to basic care, and the impetus for the ACA was a desire to stop leaving millions of Americans behind, one serious ailment away from financial ruin.
And even if we put aside all of the ACA's many other successes and breakthroughs, on this point alone the law is succeeding beautifully.
The share of Americans without health insurance dropped to its lowest level in seven years in 2014 as President Barack Obama's overhaul took full effect, according to an extensive survey released Tuesday. The Gallup-Healthways Well-Being Index found that the trend appears likely to continue this year, since 55 percent of those who remained uninsured told the pollster they plan to get coverage rather than face escalating tax penalties.
Of the nation's 50 states, how many have seen their uninsured rate go up? Zero. The Affordable Care Act has been implemented differently in different states, so improvements vary widely, but in literally every state, there's been real progress.
Just as important, the more a state cares to govern effectively, the better the results -- as the AP's report noted, of the 11 states with the biggest declines in their uninsured rates, 10 of them have embraced both Medicaid expansion and a state-based exchange marketplace.
From 2013 to 2014, Arkansas and Kentucky have seen stunning, double-digit drops in their statewide uninsured rate -- an improvement that hardly seemed possible. Indeed, Kentucky, which has been a national model for ACA implementation, has gone from an uninsured rate over 20% to one under 10%.
The only notable bad news, as Emily Cohn noted, is that states that refuse to implement the ACA effectively are the states where residents are struggling most: "The states with the highest uninsured rates in 2014 are pretty much all found in the South, the Gallup poll found."
Don't underestimate the scope of the damage Supreme Court Republicans may do.