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Has Obamacare been a success?

What is going on

President Biden has always viewed the Affordable Care Act (ACA), the major health care reform commonly known as Obamacare, as a “big deal.”

Last weekend he marked the 14th anniversary of the bill’s signing, not with a celebration, but with a warning that this could be at risk if Donald Trump regains the presidency.

In 2017, Trump managed to fulfill his campaign promise to repeal the law within one vote in the Senate “broken mess” of the health care reforms adopted by his predecessor. Although that attempt failed, he was able to undermine certain provisions of the law during his time in office. Yet the core of the ACA remains intact and has even been strengthened under Biden.

Trump has sent mixed signals about whether repealing the ACA is still one of his goals. Late last year he wrote that “Obamacare Sucks!!!” and said he is “seriously looking at alternatives” if he runs again in separate posts on Truth Social. However, on Tuesday he claimed that he is not looking to end the law, but instead wants to make it “MUCH, MUCH, MUCH BETTER FOR MUCH LESS MONEY.”

Trump’s hedging could be a response to how much public opinion on the ACA has improved since the Republican Party tried to repeal it. Some Republicans even worried that Trump’s criticism could hurt him and the party in the 2024 elections.

Obamacare was passed in 2010 and made major changes to the way the US healthcare system works. It bans insurers from denying coverage due to pre-existing conditions, established a list of “essential health benefits” that must be covered, ended annual and lifetime spending caps, created exchanges where patients can find a health care plan, and restricted access to Medicaid expanded so that millions more are low. -income Americans are eligible for government-funded health insurance.

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Opposition to Obamacare was one of the defining issues for the Republican Party in the early 2010s, and the Republican Party’s message — based in part on false claims about what was in the bill — resonated with the public. In 2013, only a third of Americans had a positive view of Obamacare. Today, almost 60% of voters approve of the law.

Why there is discussion

Although Obamacare appears to have become a net positive for Democrats politically, there is still much debate about whether the ACA has improved America’s healthcare system.

Obamacare’s proponents say it has been a major success in its main goal: making health insurance more accessible. Since the law was passed, the number of Americans without health insurance has fallen by more than half, and last year a record 40 million people gained coverage through benefits created by the ACA. Supporters add that the law also put an end to some of the most egregious practices in the insurance industry.

Obamacare’s opponents are quick to point out that the U.S. still spends about twice as much on health care — and produces worse outcomes — than other rich countries.

Arguments as to why this is the case differ based on political ideology. Conservatives argue that the ACA has contributed to skyrocketing health care costs by reducing consumer choice and robbing insurers of key mechanisms they used to keep premiums low. Critics on the left, however, say Obamacare is a failure because it has left the country’s profitable health care industry in place, rather than creating a truly universal system.

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What’s next

Democrats view protecting Obamacare as a winning message for them in the upcoming elections, but the Republican Party’s apparent hesitation to engage on the issue could limit the issue’s resonance with voters when they cast their ballots in November bring out.

Perspectives

Increasing coverage is not enough if people cannot afford care

“Above all, one thing remains clear: ACA supporters fail to realize that better access to health insurance does not simply equal access to affordable health care services. The American people certainly deserve better.” —Brian Gomez, CT Mirror

The ACA would be more effective if the Republican Party had not spent a decade making it weaker

“Not everyone who wants insurance can purchase it, and many who do have insurance are still struggling with out-of-pocket costs. Some of these challenges are due to shortcomings in the drafting of the ACA; others are a result of the Republican Party’s ruthless sabotage efforts.” –Catherine Rampell, Washington Post

Obamacare is far from perfect, but we are still better for it

“Without a replacement health care program – which Republicans never proposed – the old system would return in which health plans in the individual market had the authority to deny coverage to people with pre-existing conditions or charge them high premiums.” – Michael Hiltzik, Los Angeles Times

Republicans have had to fabricate criticism because the ACA is actually so effective

“Conservatives have attacked Obamacare for years for a series of mostly imagined design flaws. They claimed it would create death panels, increase health care costs, or fail to reduce the number of uninsured people. None of these predictions came true. The costs of health care have been significantly lower than the drafters of the law had predicted.” — Jonathan Chait, New York magazine

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Under the ACA, we pay more for the same quality of insurance

“The reality is that ObamaCare has increased healthcare costs while delivering few tangible benefits to patients.” – Editorial, Wall Street Journal

Obamacare should not be eliminated, but it should be significantly rolled back

“With Obamacare now firmly entrenched, it would be inappropriate to frame the conversation in terms of a ‘root-and-branch repeal.’ Instead, Republicans should strive for a health care system that is more decentralized, patient-centered and efficient — and be willing to undo aspects of the health care law that stand in the way of this.” – Editors, National Review

The ACA’s heavy-handed government intervention has made health care even less affordable

“No one would believe a politician who claimed that new government-mandated rules, features and amenities for new cars would lower car prices. The new features and amenities might be nice, they might even make a car safer, but they would increase the cost of a car. And that increase would price some people out of the market. The same applies to health insurance. There are costs associated with government insurance mandates. And many mandates involve major costs.” – Merrill Matthews, The Hill

Americans have less power to decide which health insurance is best for them

“Big Government is a home run for Big Business. Obamacare means consumers have less choice.” – Timothy P. Carney, Washington examiner

Any reforms that leave profit insurance intact are doomed to failure

“More than half a century of such well-intentioned, piecemeal policies have made it clear that continuing this approach represents the triumph of hope over experience. … The only solution is universal coverage that is automatic, free and simple.” – Liran Einav and Amy Finkelstein, New York Times

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