And do you know what?  The Affordable Care Act is working — despite the enormous Republican commitment to its failure.

Republicans have prevented millions of struggling people from getting affordable coverage — your housekeeper, say, who works hard for you (and spends more than two hours a day on the bus, unpaid, just getting to you and her other clients).  The Medicaid expansion is there for her if only her Republican governor had decided to accept 100% federal reimbursement to fund it (the first few years, 90% thereafter).

They’ve done their best also to see “the exchanges” fail. (In states like Kentucky, New York, and California, where governors wanted their constituents to have access to affordable care, the exchanges have worked well.)

And they’ve spent massively to discourage people from getting health insurance.  (Will they next work to discourage people from buying flood insurance? wearing seat belts? recycling?)

Yet despite all this, it’s working.

You’ve likely seen the numbers by now.

It turns out that the famous “7 million” target was not just met — when the dust settled at the April 15 deadline . . .

  • Eight million had signed up — 35% of them under 35 years old, virtually the same youth percentage that signed up in Massachusetts in their first year of health reform.
  • And, yes, they’re paying their premiums.
  • A further 3 million young adults gained coverage by being able to stay on their parents’ plan.
  •  3 million had enrolled in Medicaid and CHIP from October to February, with further enrollment to continue year-round.
  • 105 million of us no longer have to worry about the “lifetime caps” many didn’t even realize their policies had.
  • Up to 129 million with pre-existing conditions – including up to 17 million children – no longer have to worry about being denied health coverage or being charged higher premiums.
  • And the 200 million of us without pre-existing conditions don’t have to worry about developing one.
  • Tens of millions with private insurance are now covered for preventive health care services not previously covered, like mammograms, birth control, or immunizations.
  • 37 million Medicare recipients received at least one preventive service last year at no out of pocket cost.
  • Tens of millions have gained expanded mental health and substance abuse treatment benefits.
  • Almost 8 million seniors have saved nearly $10 billion on prescription drugs as Medicare’s “donut hole” gradually closes.
  • Millions have gotten rebate checks from insurers now required to use at least 80%-85% of our premiums for health care, limiting their operating expenses and profit to 15 or 20 cents on each dollar (depending on the size of the plan).
  • Health-care-cost growth is slowing: Since the law passed, real per capita health care spending has grown at the lowest rate on record for any three-year period, less than one-third the long-term historical average stretching back to 1960.
  • The deficit is shrinking:  The Congressional Budget Office had previously projected that the ACA would reduce the deficit by $1.7 trillion over two decades.  This week, they estimated that lower-than-expected Marketplace premiums and other recent developments will cut a further $104 billion over the next ten years.  And that lower premiums will persist, running 15% below projections in 2016.
  • Medicare spending growth is down:  This week, for the fifth straight year, the CBO reduced its projections for Medicare spending over the next 10 years – this time by $106 billion.  They project that Medicare and Medicaid costs in 2020 will be $180 billion below their 2010 estimates.  And the ACA’s Medicare reforms may have “spillover effects” that reduce costs — and improve quality — across the rest of the health care system, not just in Medicare.

How about sending this to everyone you know?  It’s really good news.  Like our kids not dying overseas and the stock market being at record highs and the American auto industry thriving.  We should enjoy these things, even as we try to persuade our Republican friends in Congress to allow votes on putting the unemployed back to work rebuilding our crumbling infrastructure . . . and raising the minimum wage . . . and enacting comprehensive immigration reform . . . and passing ENDA . . . and extending unemployment benefits until the economy improves . . . and requiring background checks before nut jobs can buy assault weapons — all things that the voters, by wide majorities, want.  Wouldn’t that be a good idea?

On a lighter note . . .


You will almost surely be amused. (Thanks, Alan!)


Apparently, the above is real.  [OOPS.  NO IT’S NOT.]  I’m a lot less certain the same is true of this anecdote — but who cares?  It has the same refreshing take-no-prisoners quality. (Thanks, Michael!)

During the final days at Denver’s old Stapleton airport, a crowded United flight was canceled.  The single agent was rebooking a long line of very inconvenienced and frustrated travelers.

Suddenly an angry passenger pushed his way to the desk in front of all the others. He slapped his ticket down on the counter and said, “I HAVE to be on this flight and it has to be FIRST CLASS.”

The agent replied, “I’m sorry sir.  I’ll be happy to try to help you, but I’ve got to help these folks first, and I’m sure we’ll be able to work something out.”

The passenger was unimpressed.  He asked loudly, so that all the passengers behind him could hear, “Do you have any idea who I am?

Without hesitating, the gate agent smiled warmly and grabbed her public address microphone. “May I have your attention please?” she began, her voice bellowing throughout the entire terminal. “We seem to have a passenger here at the gate WHO DOES NOT KNOW WHO HE IS. If anyone can help him find his identity, please come forward to the gate.”

With the folks behind him in line now laughing hysterically, the man glared at the United agent, gritted his teeth, and spat out the words, “F*** you.”

Without flinching in the least, the agent smiled politely and said, “I’m terribly sorry, sir, but I’m afraid that you’ll have to stand in line for that, too.

The man retreated as the people in the terminal applauded loudly and cheered. Although the flight was canceled and people were late, they were no longer angry at United.

Have a great weekend.



Comments are closed.