In 2014, America’s stubbornly high poverty rate didn’t change. Middle-class incomes remained flat. But do you know what improved a bunch? The uninsured rate. The Census Bureau reports Wednesday that the percentage of Americans without health coverage fell from 13.3 percent in 2013 to 10.4 percent last year, with progress in every single state. All told, there 8.8 million fewer people without a medical plan.
For which you should say, “Thanks, Obamacare.” Last year, two big pillars of the health law finally moved into place. First, the Medicaid expansion, which extended coverage to more working-age adults, went into effect. Second, Americans were finally able to start shopping for coverage on the Affordable Care Act’s exchanges with the help of subsidies. Unsurprisingly, the big coverage gains were concentrated in Medicaid and directly purchased plans, such as those available on the government marketplaces. If more people were becoming insured simply because the economy was healing, you’d expect a large jump in the number of people with coverage through their employers. But the changes in job-based insurance were statistically indistinguishable from zero in 2014.
“Most of the coverage gains we’ve seen can be attributed to the big policy changes we saw in 2014, which were the expansion of Medicaid and the availability of coverage through the marketplace,” Rachel Garfield, senior researcher at the Kaiser Family Foundation, told me.
Also notable: As previous surveys have suggested, the declines in the uninsured rate have been much greater in states that have expanded Medicaid than states that have chosen not to, largely out of political opposition to the health care law. Republicans in state government have been turning down essentially free money, and their residents are going without coverage because of it.
There have been many, many failed predictions about Obamacare’s sure demise over the years—in conservative eyes, its failure has always just been around the bend. I expect that, in the future, most of the manufactured hysteria will be about supposedly spiraling, unsustainable costs for the government and consumers or some such. But for now, just remember that the law has been doing a very good job fulfilling its main goal of getting more people insured.