The Affordable Care Act: 10 years old

Last week marked 10 years since Congress passed the Affordable Care Act, said Dan Mendelson in Forbes.com, and debate over President Obama’s signature legislation “still rages.” The ACA provided insurance to an additional 20 million Americans, as the percentage of uninsured adults under age 64 plunged from 22.3 in 2010 to 12.4 today. “Obamacare,” as Republicans derisively nicknamed it, polls higher now than ever, and the popularity of many of its provisions—particularly its requirement that insurers cover people with pre-existing conditions at no additional cost— makes repealing the ACA a virtual “impossibility.” Since Republican attempts to kill the ACA were thwarted in Congress, GOP-controlled states and the Trump administration are pushing forward with a lawsuit asking the Supreme Court to abolish the entire ACA, said Andy Slavitt in USA Today. Covid-19 exposes the “absurdity” of that effort. Imagine 20 million people suddenly losing health coverage amid a viral pandemic.

“This anniversary is no cause for celebration,” said Sally Pipes in the Washington Examiner. “Ten years and more than $1 trillion” in federal spending revealed the false promises of the ACA, most infamously Obama’s pledge: “If you like your health-care plan, you’ll be able to keep it.” Insurance premiums have “skyrocketed” since 2010, and deductibles have jumped 30 percent. Taxpayers face the additional burden of covering “15 million additional enrollees” to Medicaid.

The expansion of that program has “decimated” rural hospitals, said David Catron in Spectator.org. Medicaid pays facilities less than the cost of care. Many rural hospitals treat a disproportionate share of Medicaid patients and have been driven out of business. How does that help those patients?

Coronavirus is forcing the U.S. to rethink its “grossly unequal health-care system,” said Michelle Goldberg in The New York Times. It delivers “good care for those at the top,” but not for everyone else. As “waves of sick people crash into undersupplied hospitals,” all Americans have to compete for the same limited resources, including ventilators. People without coverage or treatment are more likely to spread the coronavirus— demonstrating that nobody is safe “until everyone is.” Since the Ronald Reagan era, “America has tended to value individual market choice over collective welfare.” That idea was “crumbling” before coronavirus, and “the pandemic should annihilate it for good.”