6 Takeaways on Obamacare’s Progress and Why GOP Critics Are Backing Off

Republicans seem to be easing up their political attacks on Obamacare as the 2014 elections rev up and some new studies suggest why—the law expanding health insurance options has increased coverage in the states where it has been most fully embraced. In other words, the Affordable Care Act is helping millions of people where the private insurance marketplace did not.

“More people say that they are getting their information on the law from personal experience and from the experience of family and friends, and fewer say that they are getting it from the news media, which they also say focuses mostly on politics and not what the law means for them,” Drew Altman, Kaiser Family Fund CEO, said Tuesday in a Wall Street Journal blog. “Increasingly, public perception of the law is about people’s experiences—whether good or bad—rather than ideology and partisan politics.”

Altman’s comments are confirmed in a report released Wednesday by Wallethub.com, which compared several studies that tried to estimate how many previously uninsured people were now covered by Obamacare, as opposed to people who had insurance and switched their coverage to ACA policies. The Kaiser Family Fund’s estimate that 57 percent of Obamacare enrollees were previously uninsured was touted as the most credible finding, Wallethub.com said, rejected much lower figures generated by the Republican-friendly consultants, Rand Corporation and McKinsey.

Here are six takeaways from the Wallethub assessment.

1. Blue States Have Fewer Uninsured Residents. This is hardly a surprise, considering that Republican governors in two-dozen red states have done almost everything they can to ignore the law, especially not opening state-run Medicaid programs to cover the poor. The five states with the biggest drops in uninsured people were West Virginia, Oregon, Rhode Island, Kentucky and Washington. In West Virgina, the percentage of uninsured people dropped by almost 11 percent. In Kentucky, the percentage of uninsured dropped 8.35 percent. In contrast, the states with the smallest drops were South Dakota, Nebraska, Wyoming, Alabama and Mississippi.

2. Lower Income People Needed Help And Got It. Medicaid is the state-run health insurance program for the poor. Under Obamacare, states received federal funds to open enrollment in Medicaid. Not surprisingly, the states with the biggest expansions in health coverage also saw the biggest bumps in Medicaid populations. The top five states where per capita enrollment jumped under the ACA were: West Virginia, Oregon, Kentucky, Rhode Island and Washington. Conversely, the states with the fewest new Medicaid enrollees were states that previously had well-established Medicaid programs: Hawaii, New Jersey, New York, the District of Columbia and Illinois.

3. Obamacare Is Helping Millions To Buy Insurance. Before the ACA, many people could not buy health insurance because the insurers would reject people they deemed to be too costly—especially individuals with prior medical issues and just about everyone older than age 50. The top five states where uninsured individuals were now able to buy coverage were: Florida, Idaho, Montana, North Carolina and California. In contrast, the five states with the fewest new private insurance enrollees were: West Virginia, Iowa, Minnesota, Hawaii and Massachusetts. Some of those states saw big jumps in their Medicaid enrollment, which means the ACA is helping their poorest individuals.

4. Obamacare Is Reducing The Uninsured Despite Obstacles. Wallethub.com’s figures are followed by an analysis from a range of policy experts, some of whom are repeating Republican talking points. But among those who are taking a less-partisan stance, the law appears to have reduced the number of uninsured Americans by 5-to-9 million people, Washington and Lee University Law School’s Timothy Jost said. “The ACA has begun to make good inroads into covering the uninsured. But as the law is structured, we will probably never cover everyone,” said Northwestern University’s Joel Shalowitz.

5. Significant Hurdles Are Now Stalling Better Implementation. The best-known barrier to implementing the law is the refusal by most GOP governors to expand their state Medicaid programs. But there are other less high-profile obstacles, the analysts noted. Verifying applicants’ immigration status is delaying 1.2 million enrollees, and income information for another 960,000 people has not yet been verified, the federal Office of Inspector General reported, according to Wallethub.com. Another big obstacle is that smaller states, notably in New England, are not offering a wide array of health plans, compared to big states, because private insurers are not participating, it said.

6. Many Americans Still Don’t Know What Obamacare Is. Public misconceptions about the law undoubtedly are due to the GOP’s misinformation barrage. Washington and Lee University’s Jost said that the biggest misconception was “that it is a government takeover of healthcare. In fact, it is a heroic attempt to make markets work in healthcare as they have not in the past.”

According to the University of Minnesota’s Stephen T. Parente, the biggest misconception was that “it is national health insurance and everyone gets covered. In reality, it is a relatively modest change to the private health insurance system focused mostly on the fairly small individual and small employer market.”   

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