A Tea Party member reaches for a pamphlet titled "The Impact of Obamacare", at a "Food for Free Minds Tea Party Rally" in Littleton, New Hampshire in this October 27, 2012.
Jessica Rinaldi/Reuters

Away from Gruber theatrics, ACA keeps succeeding

The right decided weeks ago that Jonathan Gruber is the Single Most Important Person In America, which necessarily means House Oversight Committee Chairman Darrell Issa’s (R-Calif.) show trial hearing this morning should be considered the Single Most Important Story, at least according to conservatives.
But I continue to believe that while Republicans’ Gruber-mania is no doubt great for fundraising and right-wing mobilization, it’s also a pointless distraction from the one fact the GOP is desperate to avoid: the Affordable Care Act is working.
Dylan Scott noted yesterday, for example, the success of the “medical loss ratio” provision of the law, which is “working exactly as it’s supposed to.”
A key provision of the Affordable Care Act that was designed to keep insurers from overspending on administrative costs or else be forced to rebate premiums to customers looks to be succeeding in not only reducing those costs but in lowering premiums.
A new report from federal health officials, which concludes that health spending had grown at a historically slow rate in 2013, says the so-called MLR provision is helping drive the broader easing of spending growth in the industry.
The medical loss ratio may sound obscure and complicated, but as long-time readers may recall, it’s pretty straightforward: private insurers are required to spend 80% your premiums on your medical care, and 20% on everything else (overhead, advertising, corporate salaries, etc.). When an insurer spends less than 80% on care, the company is required to send you a check for the difference.
This has led to plenty of American consumers receiving unexpected checks in the mail, but as the TPM report makes clear, the 80/20 ratio is also having a positive impact system-wide.
All of which adds up to a simple truth: Gruber may be political catnip, but as a substantive matter, “Obamacare” is enjoying one success after another. Indeed, it’s probably time for a new T-chart:
There’s no denying that the politics of health care remain a mess. Gruber has become an obsession; Sen. Chuck Schumer (D-N.Y.) is needlessly criticizing the effort to pass health care reform in the first place; Republicans on the Supreme Court may yet destroy the system for no reason; and polls show much of the country still opposes the law, even if clear majorities support what’s in the law.
But looking past politics and focusing on the real-world effects of the law paints a pretty encouraging picture for ACA proponents. The system is actually working better at this point than even many optimists had predicted.