Most news is bad news. And political campaigns are more likely to flag what is wrong with our country than what is right with it. So, it’s not surprising that in the heat of a presidential election, we are more focused on what is wrong with our country than what is right with it.
But as the federal government updates its statistics on income, poverty and health care this week, we can take a moment to appreciate the good news—government at the federal and state level has been increasingly successful at encouraging broadly prosperity.
We start today with health care. The Affordable Care Act remains controversial and even those of us who support it recognize that further reforms are needed to guarantee that quality health care remains affordable to everyone.
There can be little doubt that the ACA is working in Pennsylvania and beyond. Between those who bought health insurance on the Pennsylvania Exchange, and those who were newly eligible Medicaid—which happened when Tom Wolf became Governor—the number of people who were uninsured in the Commonwealth declined by 420,000 from 2013 to 2015. In 2013 9.7% of Pennsylvanians did not have health insurance. In 2015, only 6.4% did not.
There is no question that the expanding Medicaid in Pennsylvania made a huge difference. We won’t have detailed information about how Pennsylvanians secure health insurance for another day or two. But nationwide, states that expanded Medicaid saw the uninsured rated drop from 12.8% to 7.2%. But in states that did not expand Medicaid, the uninsured rate only dropped from 16.9% to 12.3%.
Studies of the ACA nationwide and in particular states have shown that it already has improved health care for millions of people. All kinds of people have benefitted but those most likely to lack coverage in the past, such as racial and ethnic minorities, young adults, part-time workers, people with less education, and low-income families, have done so most dramatically. And the impact has been felt where it matters most, on the health of recipients of Medicaid. An examination of Medicaid in Oregon showed that “compared with similar people without coverage, people with Medicaid were 40 percent less likely to have suffered a decline in their health in the previous six months.” Other research shows that the expansion of Medicaid coverage for low-income adults in Arizona, Maine, and New York reduced the death rate in those states by 6.1 percent. We can expect similar good results in Pennsylvania.
These benefits have been achieved not only without dramatic increases in health care costs but while the growth in overall health care costs has slowed down and are now projected to be $2.6 trillion less between 2014 and 2019 than projections made right after enactment of the ACA. And while aggregate health care costs recently ticked up again, they are growing at rates substantially below the average of the last 15 years and are likely to be the result of the expansion of health insurance to those who lacked it before. On a per per enrollee basis, health insurance costs for those who have private insurance and Medicare are still growing at historically low rates. And costs per enrollee for Medicaid have continued to be substantially lower than for either private insurance or Medicare.
There is no question, then, that the ACA and other federal and state programs do a great deal to improve the health of hundreds of thousands of people in Pennsylvania.