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A Year in Grading Obamacare on a Curve

There was a lot of over-promising and under-delivering.

Now that it has been roughly a year since most of the major elements of the Affordable Care Act launched, the New York Time takes a look at how the law is working out and Paul Krugman labeled it a success.

The Times has a very nice survey of the results to date of the Affordable Care Act, aka Obamacare, aka death panels and the moral equivalent of slavery.

The verdict: It’s going well. A big expansion in coverage, which is affordable for a large majority; the main exceptions seem to be people who went for the minimum coverage allowed, keeping premiums down but leaving large co-payments. None of the predictions of disaster has come even slightly true.

Krugman can say it is working well because he is grading it on the curve set by Republicans. It is true the law didn’t produce many of the dystopic nightmares they claimed. This is a legitimate way to judge the law since the Republicans made this prediction bed, they should be made to sleep in it.

At the same time, grading the law on the curve of Democrats’ predictions it gets a dramatically worse grade.

Is shopping for insurance on the new exchange as easy as using Kayak to book a flight? The answer here is clearly no.

Is the Affordable Care Act “affordable” for everyone? The answer is yes for some, but also no for others. For people buying an individual policy making over 250 percent of the poverty line, they face high premiums. In addition, the high deductibles combined with health cart industry’s newest tactics to hit people with surprise fees means many can’t afford to use the coverage.

If you liked your policy did you get to keep it? While most people’s policies weren’t impacted by the law, this blanket promise from Obama was clear a lie. There were some people who could not keep their policy because of direct and indirect changes resulting from the law.

Is it “universal” health insurance? Again, the answer is the law falls short of the big promise. While it will increase the number of insured, it will leave us short of that promise. Part of the problem is state Republicans refused to expand medicaid, but part of the problem is with the law. It still left some real holes that make coverage unaffordable for some.

Are people no longer one illness away from financial ruin? Not really. While the law has improved things for some, like those who qualify for Medicaid, the high out-of-pocket limits on many of the exchange’s policies will still leave many who took part in the program struggling to afford treatment.

Judging Obamacare by the promise made by Obama, the grade it deserves after a year is “not exactly.” There was a lot of over-promising and under-delivering. I think this is how many people are grading the law, which is probably part of the reason that after a year the law is still unpopular.

Photo by Jake Johnson under Creative Commons license

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Jon Walker

Jon Walker

Jonathan Walker grew up in New Jersey. He graduated from Wesleyan University in 2006. He is an expert on politics, health care and drug policy. He is also the author of After Legalization and Cobalt Slave, and a Futurist writer at