At Sen. Tom Cotton’s town hall recently a demonstrator shouted “Obamacare saved my life”. This, of course, was the lead clip of the demonstration repeated endlessly on cable news because it fits the false narrative that Obamacare provides health care.
If the demonstrator’s life was saved, the truth of which the media thought not important enough to confirm, it was not saved by Obamacare. No, snowflake, Obamacare didn’t save your life, it might have paid your doctor, but it didn’t save your life. Your shout was a slogan not a statement.
Obamacare is health insurance. It is not health care. Health insurance pays for health care, it does not provide it. Doctors and hospitals provide health care. To say that Obamacare saves lives is misleading hyperbole. Obamacare just makes paying for health care more expensive.
No , Obamacare Has Not Saved American Lives
The arguments of the law’s defenders don’t stand up to scrutiny.
Repealing the Affordable Care Act, Democrats say, will “make America sick again.” Bernie Sanders warns “36,000 people will die yearly as a result.” But as with most ACA defenses, these claims describe an imaginary health-care reform that works, not the legislation passed by Congress in 2010. In reality, the best statistical estimate of the number of lives saved each year by the ACA is zero.
Some studies do suggest that health insurance can saves lives. But these focus either on individuals with private coverage or on the Massachusetts health-care reform law of 2006, which primarily expanded private coverage within the Bay State. The ACA, by contrast, is primarily an expansion of Medicaid; in recent years, the share of Americans with private insurance has declined.
In 2007, just prior to the Great Recession, 66.8 percent of non-elderly Americans had private insurance. By 2015, two years into the ACA’s expansion, that share had declined to 65.6 percent. Taking the larger economic picture into account by looking back to 2007 is crucial, because the private-insurance rate fluctuates with employment. Between 2007 and 2010, employment fell by 5.5 percent and private coverage fell by 7 percent. Between 2010 and 2015, employment rose by 8.8 percent and private coverage rose by 9.5 percent.
Instead, the ACA has increased insurance coverage by expanding Medicaid. In 2007, 18.1 percent of non-elderly Americans had public insurance. By 2010, that share was 22 percent, and rather than declining as the economy recovered, it continued to climb all the way to 25.3 percent in 2015.
This public-versus-private distinction is crucial, because studies of Medicaid do not find the same positive effects on mortality sometimes seen in studies of private insurance. Researchers have found that Medicaid patients with a variety of conditions and medical needs experience worse outcomes than similar uninsured patients. In a randomized trial in Oregon that gave some individuals Medicaid while leaving others uninsured, recipients gained no statistically significant improvement in physical health after two years.
In the New England Journal of Medicine, a team at Harvard University compared three states that expanded Medicaid in the 2000s with others that made no change; only one of the three achieved a statistically significant reduction in mortality. In the Journal of the American Medical Association, Stanford University’s Raj Chetty and colleagues looked for determinants of life expectancy for individuals in the lowest income quartile and found that health-care access was not one of them.
There is one exception to this trend: Medicaid may have significant positive effects on pregnant women and young children. But once again, the ACA is not that policy. Under the Children’s Health Insurance Program, created with bipartisan support in 1997, those groups were already eligible for Medicaid or a comparable program at the income levels to which the ACA expanded coverage for other adults. An identical 42.2 percent of children had public-insurance coverage before the ACA’s Medicaid expansion in 2013 and after its expansion in 2015.