The scope of the Affordable Care Act was extraordinary, reaching every part of the nation’s expansive health care system. But at its root, the ACA had one overarching goal: to reduce the uninsured rate by bringing affordable coverage to millions of Americans. The United States had one of the highest uninsured rates in the industrialized world, and reformers believed the ACA would make it better.
That progress faltered a bit during Donald Trump’s presidency, as the Republican administration’s policies pushed the uninsured rate a little higher, but as USA Today reported, the Biden administration is now celebrating the lowest uninsured rate on record.
A record low 8% of Americans lacked health insurance at the start of the year, according to an analysis by the U.S. Department of Health and Human Services provided first to USA TODAY. More than 5 million people have gained coverage since 2020, according to the department’s review of household survey data.
Better yet, the same data showed the strongest improvements among low-income Americans.
To be sure, an 8 percent rate is still higher than it should be, and it reminds us that there are still millions of Americans who lack coverage. The uninsured rate would be significantly better were it not for Republican officials in 12 states who continue to reject Medicaid expansion through the ACA for reasons that defy common sense.
But as frustrating as this dimension to the policy debate remains, it’s still worth celebrating good news: Before the Affordable Care Act passed, it was difficult to even imagine a rate this low.
Not surprisingly, the White House touted the data with great enthusiasm. In fact, in a written statement, President Joe Biden took some credit for the news, declaring, “This progress did not happen by accident.”
As a factual matter, the Democrat has a point. Biden and his congressional allies took a variety of deliberate steps early last year that made a big difference for millions of families. Indeed, not only did the administration significantly bolster outreach efforts, encouraging and helping consumers enroll in ACA plans, but Democrats used the American Rescue Plan to make coverage much more affordable — with some consumers seeing their premiums fall to nearly or literally zero.
The bad news is that those insurance subsidies are set to expire later this year. The good news is that the Democrats’ Inflation Reduction Act would keep the low insurance rates in place for three more years.
There is, however, continued uncertainty as to whether Arizona Sen. Kyrsten Sinema will derail the legislation in order to protect tax breaks. If she does, ACA prices will spike, many will find insurance far more difficult to afford, and the progress on the uninsured rate would end.
“The progress in health insurance coverage could all come crashing down,” Larry Levitt, executive vice president for health policy at the Henry J. Kaiser Family Foundation, told HuffPost last week.