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Good news on health care

Jun 21, 2016

Most religions have some basic creed all members are supposed to profess. Many political parties do as well.

I’m not sure what that would be for Democrats these days.

But for today’s Republicans, one basic article of faith is bitter opposition to the Affordable Care Act, perhaps better known as Obamacare.

Virtually every Republican running for federal office has vowed to work to repeal Obamacare.

Actually, they usually say “repeal and replace,” though they are usually pretty vague about what, if anything, they’d replace it with.

Polls usually show slightly more people disapprove of Obamacare than approve, though that may be misleading.

Most people say they don’t want it repealed, and some who disapprove want a more radical single-payer system.

Over time, the percentage favoring the act has been improving.

And this week, we got some hard evidence that it is working.

The University of Michigan’s Center for Healthcare Research and Transformation found that only 5% of Michigan residents reported not having health insurance – an all-time low.

Four years ago, 14% lacked insurance of any kind. Interestingly, most of those without insurance seem to be young white people who are working, but who haven’t bothered to sign up.

There’s some other good Obamacare news as well.

One of the provisions of the Affordable Care Act was the ability for states to extend Medicaid eligibility to people who are making slightly more than poverty-level incomes.

One of Governor Snyder’s rare successes with the Legislature was managing to persuade lawmakers to do that, which then gave health care to 600,000 Michiganders.

That program is called Healthy Michigan.

Yesterday, another University of Michigan study found that many of the worst fears of those who opposed extending the program were groundless.

They predicted, for example, that extending Medicaid eligibility would mean many providers wouldn’t want to see these patients. Instead, once it happened, a higher proportion of clinics reported they would take Medicaid patients.

Opponents also worried it would take much longer for patients to get to see a doctor.

That didn’t happen either, according to the study, published in The American Journal of Managed Care.

On average, patients with either traditional Medicaid or Healthy Michigan plans were able to get an appointment to see a doctor for a non-emergency situation in about a week.

Governor Snyder pushed the plan in part because, he argued, it would mean a healthier and more productive work force. I haven’t yet seen a study of that.

But common sense would indicate that has to be the case. What’s even better is that until now, the federal government has assumed all the costs of expanding coverage.

Starting now, Michigan does have to pay a small fraction of the total cost, a figure that will never exceed 10% of the total.

That doesn’t happen until 2020.

Even then, thanks to other benefits, the state will still be saving more than it is spending by expanding Medicaid, according to an analysis by the nonpartisan House Fiscal Agency last fall.

This would all vanish and all these people would lose their coverage if the Affordable Care Act were ever repealed.

My guess is that the political costs of doing that might be a whole lot bigger than some candidates seem to think.

Jack Lessenberry is Michigan Radio's political analyst. Views expressed in his essays are his own and do not necessarily reflect those of Michigan Radio, its management or the station licensee, The University of Michigan.