The first full year of the Affordable Care Act brought historic increases in coverage for low-wage workers and others who have long been left out of the health care system, a New York Times analysis has found. Immigrants of all backgrounds -- including more than a million legal residents who are not citizens -- had the sharpest rise in coverage rates. Hispanics, a coveted group of voters this election year, accounted for nearly a third of the increase in adults with insurance. That was the single largest share of any racial or ethnic group, far greater than their 17 percent share of the population. Low-wage workers, who did not have enough clout in the labor market to demand insurance, saw sharp increases. Coverage rates jumped for cooks, dishwashers, waiters, as well as for hairdressers and cashiers. Minorities, who disproportionately worked in low-wage jobs, had large gains.
When it comes to evaluating the Affordable Care Act's successes, one of the key metrics is pretty straightforward: "Obamacare" is lowering the uninsured rate to the lowest levels on record, bringing coverage to people who didn't have it. But it turns out there's an even more detailed way to consider this measurement.
The New York Times, relying largely on Census data, published a fascinating report on which American constituencies have seen the sharpest improvements thanks to the reform law, and the results point to an important angle for the larger political debate.
In other words, struggling, low-wage workers, who tend to have the least amount of political capital, have seen the biggest gains. While there's been progress among every demographic since the ACA was implemented, the Times analysis found that the reform law has narrowed "the gap between the haves and the have-nots," even while income inequality has gotten worse overall.
One of the interesting things to keep in mind is that the left and right don't necessarily have to disagree on these basic factual details, and can instead argue about whether or not the developments are worth bragging about.
Paul Waldman had a good piece on this today, highlighting the "clash of values": The left sees the Affordable Care Act bringing health security to vulnerable communities and appreciates this an inherent good, while some ACA critics on the right believe if the government helps an immigrant dishwasher receive coverage, then the government "is redistributing tax money from deserving people to undeserving people."
Who's right? It's a matter of perspective. When conservatives complain about the "redistribution" of wealth, they're not wrong -- the ACA, quite deliberately, invests resources into benefits for those without. For Obamacare proponents, this is a feature, not a bug, since the whole point of the reform effort is to expand access and ensure broader health security for the country at large.
Those at the top aren't exactly penalized -- they get better insurance, which can't be taken away, and which will be there even if find they're no longer at the top -- but they're not the biggest beneficiaries, either.
Again, there's a basic philosophical question as to whether or not these developments should be seen in a positive or negative light, but either way, the foundation for any debate is understanding the facts as they exist. And the evidence suggests the most vulnerable Americans are the ones who get the most out of the new system.
They're also, naturally, the ones who'll suffer most if Republicans control the levers of federal power next year. Whether that's seen as a tragedy or a just result depends entirely on one's point of view.