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This week in 1765, 350 years ago, Great Britain passed the Stamp Act, the law that eventually led to the Boston Tea Party and the American Revolution, even though it was repealed in 1766. It was designed to do nothing positive for the colonists it taxed, instead simply just raising money for the British treasury.
This week in 2010, five years ago, President Obama signed the Patient Protection and Affordable Care Act into law. It has not led to a revolution – yet – but if you asked your average conservative which was worse, the oppressive taxation without representation of King George or giving 16 million Americans access to affordable health insurance, they would say Obamacare every time, I'm sure.
I do not understand this.
By every objective measure, the law is a success. It's not just the millions more insured, but also the financial benefits to the overall American economy, including the health care sector.
According to Gallup, the uninsured rate in this country has fallen from 16.4 percent to 12.9 percent since the law's passage, and will probably drop further when Gallup releases numbers from this quarter sometime next month. That means more than one out of every five people who lacked insurance in 2010 has insurance now, and it puts us at the best uninsured rate in decades. In fact, 2014's Health Statistics’ National Health Interview Survey (from the Department of Health and Human Services) had the rate as of June last year lower than any year since 1972.
I could understand why conservatives would hate the law if this all came at too high a cost – lost jobs, people kicked off employers' plans, another recession or depression, massive federal deficits, or skyrocketing health care costs. But none of that has happened.
In the 59 months since the passage of the ACA, 55 months have seen positive job growth, according to the Bureau of Labor Statistics. The four months with job losses were all in 2010 shortly after passage but before it started working; since the various provisions of the law have come into effect, job growth has been uniformly positive.
I can hear conservatives asking, "But what about part-time workers?" It is true that the ACA levies penalties against companies that don't provide insurance for people who work more than 30 hours a week, and some people think millions of workers will have their hours cut to 29 or fewer. Those penalties only kick in this year and next, but the idea has already been studied and debunked.
The non-partisan Congressional Budget Office said last year that there's no evidence that employers are changing workers' hours because of the law. The very partisan Urban Institute said the same thing last year, noting changes to the number of workers who work between 30 and 34 hours a week--who would be covered by the penalties – mirrored changes in workers who work less than 30 hours a week. This suggests that any changes to part-time work are not really motivated by the law at all, but by wider conditions in the economy.
Nor are there big changes in who gets health insurance from their jobs. Mercer, a leading health-insurance analyst, released a survey of employers last week finding that over the last year, as requirements for employers have kicked in, the percentage of workers enrolled in employer-sponsored plans was unchanged.
The law has not plunged us into recession, either. Economic growth has been consistently positive the last five years (the first quarter of 2011 saw a small retraction, but GDP has been positive every quarter since).
The federal deficit has fallen by more nearly 75 percent since its Great Recession high in 2009, and more than 70 percent since the passage of the ACA. As more of the provisions of the act become effective – such as coverage on the exchanges last year and subsidies for most of those who got that coverage – the deficit is expected to increase, but only barely. The CBO's latest estimate, released this month, shows the 2015 deficit projected to be just $10 billion higher than 2014, an increase of less than 3 percent and, it seems to me, a fair trade for 16 million more people getting health insurance.
And those health care costs? Contained, and certainly not spiraling out of control. The Commonwealth Fund noted in a report in January that between 2010 and 2013, premiums for employer-sponsored insurance slowed their rates of growth, despite requirements under the ACA. News is also good for those on the marketplaces; the Kaiser Family Foundation said in January that premium growth for exchange plans was only about 2 percent for a silver plan (the plan that federal subsidies are calculated for). In Wisconsin, the cost of an average subsidized silver plan was actually lower this year.
So it's pretty clear to me that the ACA – Obamacare – is no Stamp Act. Indeed, it's hard to think of a law more derided by one side of the political divide that has been so beneficial to so many Americans. Here's to the next five years!
