Obamacare is working, whether you like it or not

By Rick Newman

Virtually all the Republican candidates want to repeal the Affordable Care Act (Obamacare), the most significant piece of legislation passed under U.S. President Obama. Even Democrat Hillary Clinton, a longtime advocate of government-sponsored healthcare, has problems with some of the ACA’s core provisions.

But politicians who want to repeal or change Obamacare face one problem: It is accomplishing what it is supposed to. “The Affordable Care Act is basically working,” says Doug Elmendorf, former director of the nonpartisan Congressional Budget Office (CBO). “The act is doing what it set out to do, which is greatly reduce the number of people without health insurance.”

Obamacare has extended insurance coverage to about 10 million people through changes in the Medicaid program, and to another 10 million through subsidized insurance policies, Elmendorf says. That’s 20 million people with insurance who would not have had it without the Affordable Care Act. When Elmendorf ran the CBO, the agency estimated the law would extend coverage to 23 million additional Americans by 2015, so the program is a bit behind projections. But it is still in the ballpark.

As the penalty for not having insurance goes up, more people will enroll.

The CBO estimates the number of newly covered people will rise to 34 million in 2016, and 38 million in 2017. That would still leave about 30 million uninsured. But the portion of Americans with coverage would rise from 81 percent before Obamacare went into effect to nearly 90 percent by 2017.

As Elmendorf points out, Obamacare comes at a cost. Extending coverage to 20 million additional Americans will cost taxpayers about US$76 million in 2015, and that will swell to about US$145 billion by 2022, at which point it is expected to level out. And some provisions are unpopular, such as the requirement for most people to buy insurance. The penalty for those who don’t will be at least US$695 in 2016.

With the Affordable Care Act thoroughly implemented, politicians who insist on repealing it are not being realistic. But it is possible, and perhaps even likely, that the law will be changed to address ongoing problems. Deductibles and other out-of-pocket healthcare costs have been skyrocketing, for one thing, which undermines the value of having insurance in the first place. And there is growing momentum to kill the “Cadillac tax” due to be imposed on the costliest healthcare plans in 2018. The ACA might be working, but that doesn’t mean it’s working well.

The original version of this article was published in Yahoo News