Remember how much Republicans wanted to repeal Obamacare?
The Republican majority in the House of Representatives has voted more than 50 times to repeal the law. Conservatives have twice brought challenges to the Supreme Court — a court with powerful voices that often lean in their direction — only to be largely rebuffed both times. The last government shutdown was driven by Republicans who insisted on defunding Obamacare (not to be confused with what may be the next government shutdown, driven by Republicans insisting on defunding Planned Parenthood).
Some suggest that the calls for repealing Obamacare are fading. Sarah Kliff argued that the “near-complete absence of Obama’s health overhaul” in last week’s Republican presidential debate was “remarkable.”
Maybe, but don’t count on it. In GOP presidential candidate Jeb Bush’s white paper on how he would get to 4 percent growth through supply-side tax cuts, his team of economists stresses that repealing the Affordable Care Act will be an “important means of enhancing economic growth.” Front-runner Donald Trump said just last week that he was going to replace Obamacare with “DonaldCare,” which would be both “absolutely great” and “really spectacular.” Repealing health-care reform remains a prominent talking point for Wisconsin Gov. Scott Walker and Sen. Ted Cruz, both GOP presidential candidates.
Well, since we don’t know what’s in it, I can’t comment on DonaldCare.
But I can tell you this about Obamacare: When it comes to meeting one of its most important goals — providing coverage to the uninsured — it is working extremely well. It’s posting historical gains on this front and, in so doing, both insulating itself from repeal and creating a daunting political challenge for its opponents.
The facts of the case are thoroughly drawn out in this new analysis by my colleagues Matt Broaddus and Edwin Park (B&P) from the Center on Budget and Policy Priorities:
— As the figure above shows, newly released census data show that the share of those without health coverage fell from 13.3 percent to 10.4 last year.
— That’s the largest single-year drop on record based on data going back to 1987.
— In this type of work, the strength of your findings are much bolstered when you see them across multiple sources. As B&P point out, the census findings are “consistent with the historic coverage gains measured in the Centers for Disease Control (CDC) and Prevention’s National Health Interview Survey and several private surveys…at 9.2 percent, the CDC’s estimated uninsured rate for the first quarter of 2015 was the lowest since the CDC began collecting these data in 1997 and more than 40 percent below the peak in 2010.”
— The ACA takes a two-pronged attack on covering the uninsured, subsidizing private coverage through the exchanges and expanding Medicaid in the 25 states (as well as D.C.) that accepted that part of the deal. Both private and public coverage are making significant gains.
— Speaking of anti-Obamacare ideology and its effect on people, B&P provide this revealing calculation: “If the uninsured rate had fallen in non-expansion states at the same rate as in expansion states, an additional 2.6 million uninsured Americans would have gained coverage last year.”
— Coverage last year grew most quickly among households with income below $50,000; their uninsured rate fell from about 20 percent to about 15 percent — in one year! Households above $50,000 had lower uninsured rates to start with, so we would expect smaller changes, but they, too, went from 9 percent to 7.4 percent.
Such truths are more than inconvenient for sworn enemies of the law. They can bob and weave in their primaries, but once they reach the general election, their Democratic opponent will slam them on these points. And unless they’re willing to massively flip — pretty unimaginable, given the heat generated by the issue for conservatives — people represented in the numbers and charts above will rightfully fear that their health security is at stake.
I cannot overemphasize the importance of these facts, and, yes, I know better than most that our political discourse too often exists in a fact-free zone. But the success of the ACA strikes at the heart of the dysfunction strategy employed extremely effectively by anti-government conservatives. This is the self-fulfilling-prophecy strategy that campaigns on: “Washington is broken! Send me there and I’ll make sure it stays that way!”
Remember, when government messes up, when it shuts down, when it fails to address the things that matter to most people — economic opportunity, wage stagnation, affordable college — and, instead, squabbles about Planned Parenthood, the winners are those who can say: “See? We told you. Government’s broken!” Never mind that those making that case are the ones doing the breaking.
But with Obamacare, they’ve been failing, and the more we elevate that case, the closer we get to the road back to Factville.