Obamacare Marches On, Step by Step

THE AFFORDABLE CARE ACT, which has now been the law of the land for five years, is beginning to reshape the national landscape in significant ways.

According to a New York Times analysis of the ACA’s first enrollment period, about 10 million additional people gained insurance in 2014. Many of them fall into demographic groups that have historically struggled to access coverage, such as low-income Americans, people of color, and women. Ultimately, President Obama’s health law is slowly making the country more equal.

There are a few ways the ACA is accomplishing that goal. It has built-in consumer protections to ensure that insurance companies treat people more fairly. It’s created state-level marketplaces to give people new options for purchasing private plans. And it’s expanded the pool of people who are eligible for public coverage through the Medicaid program.

Health policy experts agree that adding more low-income people to the Medicaid rolls represents one of the biggest successes of the ACA so far. According to the Urban Institute, a nonprofit research group, the states that agreed to expand their Medicaid programs—27 so far, plus the District of Columbia—have seen about a 40 percent drop in their uninsured rates.

“This has been a lifesaver for me. I hadn’t seen a doctor for 11 years,” Marc Sigoloff, a freelance writer in Illinois, told me. Sigloff signed up for Medicaid and subsequently discovered he had a brain tumor.

Carol Fisher Hardaway is now covered through Maryland’s Medicaid program. She told me she has a newfound peace of mind since she doesn’t need to worry about affording the treatment for her multiple sclerosis. Her reduced stress, in fact, is quantifiable. When we talked in October, she had just found out her blood pressure was at a healthy level for the first time in nearly 15 years.

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