In the five and half years since Obamacare became the law of the land, it has transformed America's health care marketplace — in a very good way.
Around 20 million Americans, who were previously uninsured, now have coverage. This has reduced the uninsured rate to the lowest point in history. The law has cost hundreds of billions less than initially projected and overall it has helped significantly reduce inflation in health care spending. In only a short period of time, Obamacare has been one of the most successful social programs in modern American history.
On Tuesday, however, the federal government announced that premiums on Obamacare plans will increase next year by 25 percent . . . and the political world lost its collective mind. Here was yet another opportunity for Republicans to bash the law they opposed en masse and have tried for six years to repeal. Media organizations, particularly CNN, were happy to pile on, dredging up old clips of President Obama promising that if you liked your doctor you could keep him and suggesting that the latest bad news story on Obamacare highlights the law's allegedly abundant failures.
Lost in this storm of bad faith attacks were some rather salient facts. First, the premium increases announced Tuesday are very much in line with Congressional Budget Office projections made in 2010. Second, the number of people affected by these rate increases is quite small. Only around 21 million people — or seven percent of Americans — get their insurance coverage on the individual market. And of those, around half buy through an Obamacare exchange, approximately 85 percent of whom receive government subsidies to minimize the cost.
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Those few consumers affected by the rise in premiums will see much of the increase erased by a similar rise in those same subsidies. Indeed, only about 2 million Americans who receive their insurance coverage via Obamacare exchanges and make too much to receive a government subsidy will be affected. But even for these folks, their experience will depend on where they live. Some states, like Arizona, are seeing huge premium increases. Other states, like Indiana, are seeing a reduction.Meanwhile, Americans who receive their insurance via Medicare, Medicaid, the VA, or their employer (around 150 million people) will be unaffected.
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But here's the most important part of the Obamacare story being omitted. There are relatively easy ways to strengthen the law and make it work more effectively for consumers. Insurance companies that sell in the individual market could be required to participate in Obamacare exchanges. The same requirement could be made of companies that offer Medicare Advantage plans. Both steps would increase competition and thus lead to lower prices and more quality plans. Another way to increase competition would be to create a government-run public option or offer early buy-in to Medicare to those aged 55-64, which would shrink the risk pool in the individual market.
These steps are not being implemented for a simple reason: the Republican-controlled Congress, which has spent years demonizing and trying to destroy Obamacare, refuses to even consider them. Obamacare still has problems, but not because the law is a failure. It's because of politically-motivated and destructive GOP obstructionism.
Four years after the Supreme Court gave states the option to reject what amounted to free money from the federal government to expand Medicaid, 19 states have done just that. Not coincidentally, all 19 states either have a Republican governor or a GOP-dominated state legislature.
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That amounts to more than six million Americans being denied coverage because of Republican recalcitrance. One might even argue that this is a much bigger story than the announcement of Obamacare premium increases, which affects only one third as many Americans. And this is happening in places where political reporters — and presidential candidates — are spending a lot of time these days.
It's happening in Florida, where more than 1.2 million people are denied access to care. In North Carolina where close to 600,000 are affected. In Georgia, where 682,000 are missing out, and in Texas, with just under 1.2 million people who remain uninsured.
Every story of hiccups in Obamacare's implementation that points an accusatory finger at the White House, rather than Republicans who have blocked practically every effort to fix the law, rewards GOP obstructionism.
The success of Obamacare is undeniable, but so too is the identity of the culprit for its continued shortcomings. Imagine if there was a media freakout over that?
Michael A. Cohen's column appears regularly in the Globe. Follow him on Twitter @speechboy71.