Feature Briefing

One year into Obamacare: where is it now?

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g7405 (Published 05 December 2014) Cite this as: BMJ 2014;349:g7405
  1. Jeanne Lenzer, journalist, New York, US
  1. jeanne.lenzer{at}gmail.com

Jeanne Lenzer assesses how President Obama’s health policy is progressing

How effective has Obamacare been in increasing access to healthcare?

About one year since the launch of the Patient Protection and Affordable Care Act’s insurance exchange program, the overwhelming majority of the 48 million people who were uninsured in 2012, remain uninsured1—a problem that will persist for the next 10 years, according to government projections. The Congressional Budget Office estimates that 37 million people will not have health insurance in 2015 and 31 million will be uninsured in 2024.2

About 6.7 million (corrected from an earlier estimate of 7.3 million) were newly insured under the act known as Obamacare during 2014.3

Access to insurance has been liberalized in several ways: insurers may no longer deny coverage to individuals with pre-existing illnesses; young adults under age 26 may remain on their parents’ policy; and Medicaid has been extended to include some poor single adults and adults without children.

How does the public view Obamacare?

A Gallup poll conducted in November 2014 found that 37% of US residents approve of the act while 56% disapprove. This reverses earlier ratings in 2012, when 48% approved and 46% disapproved.4 Approval dropped substantially in November 2013, when millions of residents were notified that their previous insurance policies were being cancelled because they did not meet the minimum standards of the act, forcing them to buy more expensive policies.5 Disapproval also grew when some newly insured people learnt that they were responsible for large medical bills because of a complex scheme of deductibles, copayments, co-insurance, and out …

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