The New Hampshire Legislature
We bring it up because this common-sense, reality-based course of action contrasts so sharply with the dark fantasies long peddled by the Republican critics of the ACA, which has enrolled 20 million people nationwide who previously lacked coverage.
For instance, remember those warnings that Obama’s health care reform would be the great “job killer”? Sen. Ted Cruz of Texas continues to make this assertion on the campaign trail as he tries to overtake Donald Trump for the Republican presidential nomination.
In Iowa on Jan. 28, for example, Cruz said, “First of all, we have seen now in six years of Obamacare that it has been a disaster. It is the biggest job-killer in this country. Millions of Americans have lost their jobs, have been forced into part-time work, have lost their health insurance, have lost their doctors, have seen their premiums skyrocket.”
This indictment would be interesting if true, but there’s no evidence we know of that it is. As Bloomberg View columnist Albert R. Hunt noted in discussing Cruz’s assertion, the economy has added 13.7 million jobs overall since the ACA was enacted. Nearly all of those jobs are full-time, in contradiction to the prediction that the law would lead employers to reduce hours in order to avoid penalties for not providing insurance coverage for full-time workers. Instead, PolitiFact, the political fact-checking service, determined that the number of people working part-time who want full-time work has fallen by nearly 3 million.
Another supposed defect of the ACA was that it would lead to a flood of employers dropping health insurance coverage entirely and making their employees fend for themselves on the marketplace exchanges established under the law. That also hasn’t happened. As The New York Times reported earlier this week: “Most companies, and particularly large employers, that offered coverage before the law have stayed committed to providing health insurance.”
The reasons were predictable, although not predicted. Health insurance coverage remains a prime tool for recruiting and retaining prized employees (which becomes harder as the labor market tightens in a recovering economy). Another is that while the penalty under the ACA for large companies that do not provide coverage — $2,000 per employee — is far cheaper than the cost of offering coverage to employees, companies also receive a generous federal tax break for providing insurance. Thus employer-based health insurance remains, and is likely to remain for the foreseeable future, the bulwark of the system, providing coverage to about 155 million Americans this year.
So, while the ACA does have remaining challenges, such as effecting a shift from a system that rewards quantity of care to one that puts a premium on quality, those issues can and ought to be dealt with technically while not losing sight of the overall success the law has enjoyed.
