Serving the Flathead Valley & Montana since 2006. A reality based independent journal of observation & analysis. © James Conner.

 

31 March 2014

What the Affordable Care Act has accomplished

Midnight tonight is the witching hour for enrolling in one of the health insurance programs blessed by the Affordable Care Act. Missing the deadline could trigger penalties that are, officially (the Supreme Court said so), taxes. Except in those situations in which the White House is delaying the deadline for one reason or another.

In a system so Rube Goldbergish as the ACA, such chaos and confusion cannot be avoided, so the test of success is not whether all bedlam was avoided but whether most people didn’t encounter it, or encounter very much of it. By that test, the ACA is a success.

Equally important, what counts now is not how far we have to go, but how far we have come. The ACA should be measured against what it replaced, not against the gold standard of health care, the everyone covered for everyone federal zero-dollar single-payer system.

According to most reports, these are the ACA’s principal accomplishments:

  1. Millions who were not insured are now insured.

  2. Junk insurance is being replaced with insurance that does good when the policy’s holder becomes ill.

  3. For most individuals, the cost of obtaining good health insurance has been reduced thanks to (means-tested) federal subsidies.

A short history lesson for Democrats

Means testing is degrading, and meant to be, which is why the Democratic Party’s 1960 platform contained this plank:

We shall provide medical care benefits for the aged as part of the time-tested Social Security insurance system. We reject any proposal which would require such citizens to submit to the indignity of a means test — a “pauper's oath.”

All of these goods occurred despite efforts by the Republican Party to repeal or sabotage the ACS, and despite the failure of irresolute Democrats to defend the ACA when it needed defending.

Much still remains to be done. Tens of millions of Americans remain uninsured, and will even after the ACA is fully implemented, for the ACA was not designed to cover everyone. The failure to expand Medicaid in many states denies help to those needing it most and subordinates brotherly love and Christian charity to icy libertarian ideology. People will die because of these decisions.

But today, we should pause a moment to take note of how far we have come, then resume our march toward a single-payer system.