An Affordable Healthcare Act supporter (R) talks with a student (L) about the law on the campus of Santa Monica City College in Santa Monica, California, October 10, 2013.
Robyn Beck/AFP/Getty Images

ACA works (in states that want it to work)

Updated
The Affordable Care Act’s critics on the right haven’t had much luck lately, but they’ve held out hope that some good news was on the way: maybe health care premiums for 2015 would skyrocket, punishing consumer with a steep bill, which Americans would hear about before this year’s midterm elections.
 
Why would that be good news? For consumers, it wouldn’t be. But for conservatives rooting for setbacks, anything that casts “Obamacare” in a negative light, even a little, is welcome.
 
But in keeping with the larger pattern, Republicans will have to look elsewhere for bad news. Jonathan Cohn reported this week that the massive premium hikes the right was counting on aren’t happening at all, at least not yet. Cohn talked to one economist who said, “This is a collective judgment that these markets are working, contradicting the Cassandras once again.”
 
It looks like we can add this to the very long – and still growing – list of Republican health care predictions that turned out to be wrong. After a while, when a group of folks are this wrong, this often, it’s tempting to think their credibility would be called into question.
 
None of this, however, is causing ACA opponents on the right to rethink their knee-jerk opposition to the law. At the state level, their obstinacy only ends up punishing their own neighbors – Margot Sanger-Katz reports on the latest data on where the system is working best.
A new survey from Gallup shows that states that have fully embraced the health reform law are doing much better at getting the uninsured covered than those that have rejected it. States with the biggest gains were all those that both expanded their Medicaid programs to cover all poor residents and participated to some degree in setting up marketplaces where middle-income people could shop for commercial health insurance.
 
I’ve written before about the “two Americas” in health care, with richer Democratic-leaning states expanding coverage to more of their populations and poorer Republican-leaning states sitting out the expansion. The Gallup numbers demonstrate the big difference the Affordable Care Act could have for the country’s poorer states.
The results are fairly obvious: states like Kentucky and Arkansas that made an effort to implement the system effectively have seen terrific results for residents, including a sharp drop in their respective uninsured rates. The more states wanted the ACA to work, and the more energy they invested in making it work, the more successful their outcome.
 
The law still isn’t popular, largely because so many Americans don’t know what “Obamacare” is and have no idea how well it’s working, but as ACA victories continue to mount, the political landscape has changed dramatically over the last six or so months.
 
Greg Sargent added yesterday, “All of these little data points help tell a larger story … the fading of Obamacare as an issue in many states, including those with hard fought Senate races with massive expenditures such as those from the Koch group. To be sure, Dems very well could lose control of the Senate. But it is becoming increasingly accepted that even if that does happen, Obamacare might not be a major reason why – the makeup of the map and the economy could prove far more important in determining the outcome.”
 

Affordable Care Act, Health Care and Obamacare

ACA works (in states that want it to work)

Updated