Given that Obamacare has driven the country’s uninsured rate to record lows, you might have assumed that more Americans are now able to see the doctor when the need arises. You’d be right. Using data from the Behavioral Risk Factor Surveillance System, researchers from the Commonwealth Fund found that the percentage of adults who said they went without needed care in the past year due to cost dropped from 16 percent in 2013 to 13 percent in 2015.
As with all things involving the health-reform law, there was a lot of geographic variation. Kentucky, which put in a heroic effort to implement Obamacare under its previous (Democratic) governor, saw the biggest decline, with the number of residents skipping out on necessary doctor visits falling from 19 percent to 12 percent. Meanwhile, some states with high uninsured rates that refused to cooperate with Obamcare’s Medicaid expansion, like Texas, saw negligible progress; others like North Carolina and Louisiana (which didn’t expand Medicaid until 2016) did experience improvement. Overall, Commonwealth finds that the percentage of residents going without care dropped at least 2 points in 38 states. It went up by at least half a standard deviation in just one: Alabama.
The gains were strongest among low-income households and minorities, who have tended to have the highest uninsured rates. Among those earning less than 200 percent of the poverty line, the fraction skipping care fell from 28 to 24 percent.
To some extent, one could actually read these numbers as an indictment of Obamacare—after the largest health reform in a generation, more than 1-in-10 Americans still couldn’t afford to see a doctor in 2015. That is fundamentally a very sad statistic. Still, Commonwealth’s figures are a useful rejoinder to a favorite conservative criticism of Obamacare—that even if the law has driven down the uninsured rate, the plans available on the exchanges have such high deductibles that the coverage isn’t useful. The fact that fewer adults are being priced out of doctor visits, even in states that didn’t expand Medicaid, suggests that the ACA hasn’t just helped more people get covered. Rather, it has incrementally helped more people afford the medical attention they need. Too bad its days are probably numbered.
