Reality Check

Gallup finds “the lowest monthly uninsured rate recorded since Gallup and Healthways began tracking it in January 2008“:

Uninsured Rate

Jonathan Cohn wants Republicans to face facts:

Republicans and other critics of the health care law keep saying the law isn’t having much impact on the number of uninsured Americans. A few even suggest it’s having no impact at all. These arguments are just not credible anymore.

At this point, the trend in the Gallup polling clearly isn’t a blip. It points in the same direction as previous surveys, from the Rand Corporation and the Urban Institute. And it’s consistent with evidence about the raw number of people who have signed up for insurance through the new marketplaces—and, yes, who have paid their premiums.

It seems to me that the ACA is doing what it was intended to do. And can we have a moment of actual moral clarity here? Is it not simply better – better for the human beings involved, better for the economy, better for productivity, better for the deficit – if more people are insured. The more that have access to regular care, the fewer highly expensive emergency room visits in the future; the better the health of our fellow citizens, the more able they are to contribute to our common weal; and this is not to speak of the categorical moral advantage of simply giving someone their health back. We have become obsessed with process – and much of that obsession is good. It matters whether premiums are paid and what price they are and what the age mix is.

But none of this seems to me to be the real issue. Maybe it’s my Catholicism coming through, but isn’t providing for the sick a core moral task? And finding a way to harness the private sector to do so more efficiently is win-win. Which brings up a question: why aren’t the Catholic bishops doing more to support and celebrate this huge advance? It cannot be because of contraception can it? Even if you concede that point, the moral gain of this law compared with a small moral loss is undeniable. It seems to me that the bishops – including the bishop of Rome – could make that case much more emphatically than they have.

Kliff highlights details from the poll:

The gains of insurance coverage have been especially large among lower-income Americans – the people who qualify for Medicaid or insurance subsidies under the Affordable Care Act. There’s been a 5.2 percentage-point drop in the uninsured rate, for Americans who have a household income lower than $36,000 since the end of 2013.

Minorities and younger Americans have also seen steeper declines; the uninsured rate for African Americans has fallen by 7.7 percentage-points over the last four months.

Jason Millman adds:

Now that Obamacare open enrollment is over, where does the uninsured rate go from here? Gallup says the number could tick back up if some newly insured don’t pay their premiums, though evidence suggests that from 80 percent to 90 percent of those signing up for private coverage have paid at least for the first month. It’s also possible that people could gain new coverage through special enrollment periods triggered by certain life events.

Medicaid enrollment also goes all year, and a previous Rand Corp. survey showed tha temployer coverage has played a major part in driving down the uninsured rate.

Meanwhile, Pew reports that opinions of the ACA have barely budged:

Public views of the 2010 health care law have changed little over the past several months. Currently, 55% disapprove of the Affordable Care Act and 41% approve. In September, before the launch of the online health care exchanges, 53% disapproved and 42% approved.

Republicans continue to be largely united in their opposition of the health care law — 88% disapprove and 10% approve of it. Among Democrats, about three-in-four (73%) approve, while roughly one-in-four (24%) disapprove of the law. Independents remain mostly opposed to the law, with 57% disapproving and about four-in-ten (39%) approving of it.