While the presidential campaign has exposed all manner of ugliness, voters have largely been spared a topic that unleashed gushers of misinformation in past elections – the Affordable Care Act. For good reason.
Opposition to "Obamacare" was a litmus test for Republicans in the campaigns of 2010, 2012 and 2014. Based in part on conservative principles, the ACA's crime was its sponsor — Democratic President Obama.
The ACA is hardly flawless, as high premiums and narrow insurance networks are a concern. But the White House's argument that Americans would come to accept the law once it was instituted is proving to have merit. People are getting health insurance that they previously could not afford and a study out last week points to its effectiveness.
In 2012, the U.S. Supreme Court made the ACA's expansion optional for states, setting the stage for what Dr. Benjamin Sommers, an assistant professor of health policy and economics at Harvard, described to The New York Times as a "huge natural experiment." The study he and his colleagues published Monday in JAMA Internal Medicine reported that low-income people in Arkansas and Kentucky, which expanded Medicare, were generally healthier than low-income people in Texas, which did not expand Medicare. The low-income residents of Kentucky and Arkansas were less likely to postpone care or avoid taking prescribed drugs because of the cost than were their unfortunate Texas counterparts.
This supports the fundamental premise of the ACA that if people can afford health care they will get it and become healthier. Stubbornly partisan Texas officials have cost low-income residents their health and they have cost taxpayers money, as people who are sick and uninsured go to emergency rooms where the costs are extremely high.
The political ramifications of these realities are apparent this election year. Politico noted last week that three vulnerable House Republicans — Bob Dold of Illinois, John Katko of New York and Bruce Poliquin of Maine — voted against repeal of the ACA and are not campaigning for repeal. Republican Senators Mark Kirk (Illinois), Susan Collins (Maine) and Lisa Murkowski (Alaska) voted against repealing portions of the law. The ACA isn't much of a campaign issue, and where it is an issue it poses problems for long-time foes.