The Progressive
by Orson Aguilar

On its fifth anniversary, the secret of Obamacare is that it’s working.

The Affordable Care Act, signed into law on March 23, 2010, is doing precisely what it was supposed to do: provide health coverage to millions of Americans who didn’t have it and couldn’t afford it.

The numbers are stark. At the end of the third quarter of 2013, just before enrollment started under the act, 18 percent of Americans lacked health insurance, according to Gallup. This translated into more than 46 million people with scant access to health care. By the end of 2014, the uninsured portion of the U.S. population dropped to just 12.9 percent. That’s still too high, but it’s the best in years.

The rates of health coverage for Americans have improved across the board, but they’ve increased the most for the groups that have had it worst. For African-Americans, the uninsured segment dropped from 20.9 percent to 13.9 percent in just one year, while for Latinos it dropped from 38.7 percent to 32.4 percent. Looked at by income, those making less than $36,000 per year made the biggest gains, with the uninsured share for them dropping nearly 7 percentage points.

But these gains have been spread unevenly. The states that embraced the new law—setting up their own health insurance marketplaces and expanding Medicaid—have seen the biggest gains.

We’ve seen this firsthand here in California, which has led the nation in implementation, helping more than 2 million people gain health insurance in the act’s first year. But states that didn’t set up their own marketplaces and didn’t expand Medicaid deprived their citizens of many of these gains. By mid-2014, according to Gallup, the states that embraced the Affordable Care Act made nearly twice as much progress in cutting the uninsured rate as those that didn’t.

The difference was dramatic. Every single one of the ten states with the largest drops were those that expanded Medicaid and established a state-based health marketplace or joined a state-federal partnership, according to Gallup.

Ah, but isn’t the law breaking the bank? No. According to a new report from the Congressional Budget Office, the law’s costs are running less than expected because health insurance premiums aren’t rising as fast as they did before health care reform.

Obamacare is not perfect. It doesn’t cover everyone, and in a country as wealthy as ours, that’s a disgrace. And it depends too much on private health insurance, a system rife with waste and dysfunction.

But while not a perfect law, the Affordable Care Act is a good law. If Congress ever succeeds in repealing it or if the Supreme Court cuts the heart out of it (as could happen later this year), millions of Americans will suffer for no reason.

Obamacare is working, and families across America are better off as a result.