Is the Affordable Care Act starting to reduce the number of uninsured Americans?
Democrats and ACA supporters are buzzing about a new Gallup poll showing that the percentage of uninsured has dropped to 15.9 percent, the lowest level since 2008. I'd be cautious, however.
On the plus-side, this is a large survey, with a 28,000-person sample. But this line of questioning also has a history of spikes in both directions. The latest results need to be reconciled with the finding just six months ago -- in the third quarter of 2013 -- of 18 percent uninsured, the worst-ever rate. In addition, before attributing the apparent increase in coverage to health-care reform, we should remember that other forces, including the improving economy, could have a more important role.
Here's what health-care expert Larry Levitt told Greg Sargent about the numbers when Gallup began showing the number of uninsured started heading down a month ago:
It's an early possible sign of success. There's been a lot of uncertainty about the effect the ACA is having on the number who are uninsured. Clearly people are signing up, and clearly Medicaid coverage is expanding. But many had their policies canceled. This is the first sign that the net of all that is still likely a decrease in the number of uninsured — it may be moving in the right direction.
The new data should, at the very least, make us slightly more confident that Obamacare isn't radically increasing the net number of uninsured. I wouldn't go much farther than that.
These are net effects. Just as some people are paying more even though health-care inflation has moderated, some people will lose insurance even if it turns out that more people are covered. And even if we had firm data on ACA implementation and its effects, there is no clear way to assess the electoral effects of the law in 2014 and 2016.
It would be great if we could get a definitive "Obamacare works!" or "Obamacare failed!" But things don't work that way. Even when we get a lot more information, researchers are going to argue about exactly what is going well or badly, and by how much.
So, yes, Democrats have something to be optimistic about today. Beyond that, there's only one thing we can say with any certainty: Anyone who says that health-care reform has already proven to be a solid success or a total failure is talking through their partisan hat.
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(Jonathan Bernstein covers U.S. politics for Bloomberg View. He is co-editor of "The Making of the Presidential Candidates 2012." Follow him on Twitter at @JBPlainblog.)
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