Wonkblog’s Sarah Kliff has helpfully compiled “A guide to surviving Obamacare debates at Thanksgiving,” and it starts off with a good one: “Your mom wants to know whether Obamacare is a total disaster.” Kliff’s response focuses on the disastrous rollout of Healthcare.gov, the online marketplace that was supposed to allow for easy health-insurance enrollment for people who need to get coverage. With the website improving but by no means problem-free, the enrollment numbers so far are dismally low. Kliff points out that some states that built their own online marketplaces have successfully enrolled thousands of people.
I’d add to this that Obamacare is far more than the online marketplace. The Affordable Care Act has already made important changes to health insurance, like allowing children up to age 26 to stay on their parents’ plans, eliminating lifetime limits on the dollar value of coverage, and requiring insurers to spend 80-85% of their premium dollars on clinical services or refund the difference to plan members. It has advanced delivery and payment reforms that could put us on a path to paying for the quality of healthcare services, rather than just quantity. The expansion of Medicaid coverage in participating states will offer coverage to millions of people who’ve been unable to afford needed healthcare.
It’s perfectly appropriate to criticize the terrible Healthcare.gov launch. We shouldn’t let that overshadow everything the Affordable Care Act has accomplished, though.