The Good – Millions more have insurance since passage

While the Affordable Care Act has served as a partisan wedge in Congress and a lightning rod for controversy, the law has produced tangible benefits for many Americans. Five years after the law’s passage, fewer than 1 in 10 Americans lacked health insurance according to the Centers for Disease Control and Prevention.  The rate of uninsured Americans fell from 15.1% in early 2011 to 9.1% by late 2015.

Between the passage of the ACA in 2010 and early 2016, an estimated 20 million Americans gained health insurance according to reports from the Department of Health and Human Services. After the ACA’s major provisions went into effect in early 2014, an estimated 13 million Americans had health insurance by the end of 2015, leaving 28.5 million nonelderly Americans uninsured.

The Bad – Insurance exchanges are breaking down

As insurance companies back out of the national marketplace, heath care premiums for ACA subscribers will rise 25%. Fewer Americans than expected have signed up for insurance under the ACA, and crucially, not enough of those subscribers are young and healthy – able to fund the system and create a counterbalance to millions of senior citizens and millions of Americans with chronic disease that this program has benefitted. Even as premiums rise, many major insurance companies including Aetna and Blue Cross Blue Shield can no longer afford to provide coverage in many states and will pull their coverage this year. As coverage options disappear, many Americans are stuck between a rock and a hard place: legally required to have health insurance but unable to afford it, or even living in a state where no ACA insurance coverage is available.

The Ugly – Washington is playing politics with people’s health care

Taking necessary time to develop a comprehensive, workable, enduring health insurance program is important. But Republicans, now in control of both Congress and the Presidency, tried and failed to unilaterally pass a repeal and replace plan for Obamacare. They attempted to push their plan quickly and without the help of Democrats.

Democrats on the other hand are also not eager to work with Republicans on significant changes to the law. Minority Leader Chuck Schumer was quoted saying: “If they repeal without a replacement, they will own it. Democrats will not then step up to the plate and come up with a half-baked solution that we will partially own. It’s all theirs.” Like Republicans, Democrats are looking at this through a partisan lens. It should not be a question of “owning” the law. It should be a question of what will make it work best.

What’s the result of all this? Tens of millions of Americans are left in limbo while our elected officials worry more about their electoral futures than the well-being of the health care market. That’s ugly.