Health insurance is like health: If things generally are working, we take it for granted. Maybe that’s why real-world critiques of the Affordable Care Act have come to be less about its general success than about the execution of its details.
Despite ongoing concern about potentially higher premiums and narrower networks – and right-wing hyperbole about the program’s supposed “disasters” – health care reform, in general, has been working.
Remember when insurance companies could deny coverage for pre-existing conditions such as heart disease and childhood asthma? Remember when coverage was an impossible luxury for millions of working Americans or their young-adult children?
Hard to believe that dark age was just four and a half years ago.
This month, to little fanfare, yet another report counted the ways in which health care reform has succeeded. Under the ACA, or Obamacare, Latinos, who, as a demographic, have historically had one of the lowest health insurance rates in the nation, have made dramatic gains.
According to the Commonwealth Fund, a nonpartisan foundation that researches health care issues, the percentage of Latinos in this country who lacked health insurance plummeted from 36 percent last July to 23 percent this summer.
And, the report found, that drop would have been even bigger had Texas and Florida, which have large numbers of “mixed status” immigrant families, not opted against expanding Medicaid to include more working poor people.
Those states scarcely moved the needle on uninsured Latinos. But in California, which was among the 25 states where Medicaid eligibility was expanded, Latino uninsured rates were cut in half, to 17 percent.
These gains have helped to underpin a formidable expansion in health coverage, nationally and in California. Though the Commonwealth Fund reported these numbers earlier this year, they bear repeating: As of June, only 15 percent of Americans were uninsured in this country. In California, that figure stood at a mere 11 percent.
Last year, those respective numbers were 20 percent nationally and 22 percent statewide.
What has made the difference? The expansion of Medicaid and the rollout of subsidized private coverage through insurance exchanges such as Covered California.
In other words, Obamacare.
This is progress, and the good news is, there’s still room for improvement. More states are considering Medicaid expansions, and the private exchanges are just entering their second year.
With a three-month open enrollment in the exchanges set to begin in mid-November, lowering those uninsured rates even more isn’t out of the question. In fact, California’s impressive numbers actually came in spite of a rocky start early last year in registering Latinos.
The state exchange rallied to improve enrollment, and as a result, Covered California is now regarded as a national model. This year, the exchange has budgeted nearly $100 million for marketing and outreach, with more boots on the ground and expanded programs, ranging from texting campaigns to neighborhood storefronts.
California should leave no stone unturned, and the job shouldn’t stop with Latinos. Numbers could be boosted in African American and some Asian communities, too.
Other challenges loom as well: We need to make sure that the newly covered stay covered. Premiums have to be kept at reasonable levels, and we need to make sure that enrollees pay them. And, on a broader scale, there are the November elections, which could jeopardize health reform in ways large and small if the right takes both houses of Congress.
We have come a long way, but this is no time to take our hard-won health reform for granted, no matter how well things are working now.