It’s a clichéd statement across the country, one that was even lampooned by President Barack Obama himself when rallying Americans to sign up for health insurance.
Now it’s being used literally by some researchers who say the Affordable Care Act (ACA) is a success on several fronts.
A study released Tuesday in the Journal of the American Medical Association says that after two open enrollment sessions more than half a million adults report “significant” improvements in affordable health insurance, access to doctors and medications, and overall personal health.
In addition, people with chronic medical conditions reported overall improvements in health and functioning, a potential benefit from expanded health insurance and policy changes, researchers say.
“These results might reflect changes in the management of chronic conditions, peace of mind from gaining insurance, or factors unrelated to the ACA,” researchers with the Harvard T.H. Chan School of Public Health and the U.S. Department of Health and Human Services wrote in their study.
What’s Getting Better
The research team analyzed data from the 2012-2015 Gallup-Healthways Well-Being Index, a national telephone survey, involving 507,055 adults.
They found that before the ACA, all the points covered in the survey were worsening. However, by the first quarter of 2015, things had turned around.
In that time, people in the United States without health insurance decreased by almost 8 percentage points.
Those who reported not having a personal doctor decreased by 3.5 percentage points, easy access to medicine increased 2.4 points, and those reporting either fair or poor health decreased 3.4 points.
The largest decrease, 5.5 percentage points, were people reporting they were unable to afford care.
The largest improvement in insurance coverage appears to be among minorities, causing researchers to believe the long-standing disparities in access to healthcare are closing.
After the ACA was implemented, Latino adults saw the largest decrease in uninsured individuals at almost 12 percentage points. In 2012, 29 percent of all Hispanics in the United States lacked health insurance, according to the U.S. Centers for Disease Control and Prevention (CDC).
Researchers say the Medicaid expansion portion of the ACA contributed to reducing the rates of the uninsured, lack of a personal doctor, and difficulty accessing medicine among low-income adults.
“As states continue to debate whether to expand Medicaid under the ACA, these results add to the growing body of research indicating that such expansions are associated with significant benefits for low-income populations,” the study authors wrote.
A Continued Political Split
The authors did note that they don’t know for sure how much of the changes are due to the new healthcare law.
“For instance, the economic recovery may have also influenced the study outcomes, though the analysis did adjust for several potential confounders including income, individual employment, and state unemployment rates,” they wrote.
Edmund Haislmaier, a senior research fellow for health policy with The Heritage Foundation, a far-right think tank, said while the numbers follow real market data, people shouldn’t put much credence in the findings, as the results are often unreliable.
“When you have a survey, people sometimes don’t understand what’s being asked,” he told Healthline.
The ACA, which has survived many legislative and legal challenges, will continue to be a target in the future, Haislmaier said.
“Politically, it’s going to continue to be an issue,” he said. “By its very design, it’s intractably complicated.”
As expected, opposing the ACA is a common strategy for Republican presidential candidates, some promising to repeal the law should they be elected.
Wisconsin Gov. Scott Walker, who announced his candidacy earlier this month, most recently called the ACA “destructive and costly” because “workers have lost hours because of new costs faced by their employers, people have lost their insurance and cannot afford the dramatic premium and fee increases.”
Walker and other Republicans were given another opportunity to voice opposition to the ACA in June when the U.S. Supreme Court yet again upheld the law’s constitutionality. The latest battle stemmed around the law’s tax credits regarding states that participated in health exchanges.
In the opinion issued June 25, Chief Justice John Roberts said the law “grew out of a long history of failed health insurance reform” that led to more Americans without health insurance.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter,” Justice Roberts concluded.
Conversely, in his dissent, Justice Antonin Scalia accused colleagues of “interpretive jiggery-pokery” and favoring the ACA in its decisions to the point “we should start calling this law SCOTUScare.”
“And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites,” Scalia concluded.