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affordable care act

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The health insurance reform bus tour, 2009.

At a time when it can feel like America's most pressing problems aren’t being addressed, there’s some very good news on the healthcare front that everyone should know. The percentage of Americans who are uninsured has hit the lowest point in American history.

A report from the Office of Health Policy earlier this year announced that the uninsured rate hit an all-time low of 8% in the first quarter of 2022. To give some perspective, in 2010, before the Affordable Care Act (ACAalso known as Obamacare) had been fully implemented, the uninsured rate was twice as high at 16%.


To add to the drop in the number of uninsured, more Americans have purchased health insurance during the recent Open Enrollment Period through HealthCare.gov and state-based marketplaces than ever before.

“The historic 13.6 million people who have enrolled in a health insurance plan so far this period shows that the demand and need for affordable health care remains high,” Health and Human Services Secretary Xavier Becerra said in a statement.

A major reason for the increase in healthcare coverage has been the American Rescue Plan’s enhanced marketplace subsidies, state Medicaid expansions and an increase in enrollment outreach by the current administration.

Health insurance

The uninsured rate has dropped since the ACA passed.

via Office of Health Policy

Approximately 5.2 million Americans have gained health coverage since 2020. The new numbers were cause for celebration at the White House.

“From November 1st to December 15th, nearly 11.5 million Americans signed up for insurance on HealthCare.gov—about 1.8 million more people, an 18 percent increase, over the same period last year,” President Biden said in a statement. “That’s an all-time record, with enrollment still open and not counting people who have signed up for coverage through their state marketplaces. Gains like these helped us drive down the uninsured rate to eight percent earlier this year, its lowest level in history.”

Health insurance, doctors

​The ACA has gained popularity in the US.

via Pixabay

The drop in the uninsured rate is a great example of the benefits of smart policy-making in Washington. The ACA wasn’t the most popular piece of legislation when it was passed in 2010. Critics on the right demonized it as a state takeover of healthcare that would result in death panels, sky-high premiums and socialized medicine. Many on the far left thought that the ACA was bad policy because it stopped short of offering full coverage for everyone like Bernie Sanders’s Medicare for All proposal.

But over time, the ACA has become a cornerstone in American healthcare policy that has changed the lives of millions. Former President Barack Obama knew it wasn’t perfect when it was passed, but he saw it as a strong foundation to build on. Now his Democratic predecessor has done just that and we’re seeing the results.

The American public has developed a much more favorable view of the ACA since the GOP’s 2017 crusade to “repeal and replace” the bill that failed in Congress. Now, 55% of Americans have a favorable opinion of the bill versus 42% who disapprove.

“I think it’s probably here to stay,” Republican senator John Cornyn recently told NBC News, referring to the ACA.

The numbers for healthcare sign-ups during this Open Enrollment Period are definitely encouraging but things may get even better. This year’s HealthCare.gov Open Enrollment Period has been extended until January 15, 2022

The fight to save the Affordable Care Act has migrated to a new battleground: Facebook.

Since early September, a viral Facebook status has been making the rounds, claiming that the Trump administration is attempting to sabotage the law by making enrolling in a health plan on Healthcare.gov confusing and difficult.


The wording varies from post to post, but the message is largely the same. It urges users to "copy and paste" and to employ a linguistic trick meant to boost the post's prominence on the social network:

CONGRATULATIONS! The White House is trying to stop you from enrolling in Obamacare. Fortunately, your friends (like me) are posting this and using the word "CONGRATULATIONS" so that Facebook's algorithm shows this to more people. Enrollment for 2018 Affordable Care Act (ACA/Obamacare) starts November 1 and ends December 15. Snopes verified that the enrollment period was shortened and GOP has cut by 90% the funding to advertise these deadlines. Administration is also taking the website down for "maintenance" for 12 hrs at a time on weekends for most of the enrollment period when working people might most likely need to use it - doing what they can to sabotage ACA. (Please leave a comment saying, "Congratulations!" to influence FB's algorithm to increase the visibility of this posting.) THEN, PLEASE COPY AND PASTE ON YOUR OWN TIMELINE.

"[It] sucks when I'm told I don't deserve affordable health care and when it's implied it's my fault I have a pacemaker or need pain meds," says Jackie Todd, a filmmaker who posted the status to her page in September. She believes her chronic heart condition would make her uninsurable, should the Affordable Care Act be repealed.

The "congratulations!" Facebook status offers users the twin satisfactions of doing one's civic duty and hacking Facebook's mysterious "algorithm." And the accusations of sabotage jibe with recent reports that claim the Trump administration is rolling back its support for the law.

At the same time, it's hard not to be skeptical of a random post that appears in your feed.

Should you believe it? Should you share it?

That depends on a few things. And I looked into those things.

Is the information about the ACA in the post accurate? Broadly, yes. Let's break it down:

"Enrollment for 2018 Affordable Care Act (ACA/Obamacare) starts November 1 and ends December 15."

True, according to Healthcare.gov. That's six weeks shorter than the 2016 open enrollment period, which ran from Nov. 1 to Jan. 31.

"Snopes verified that the enrollment period was shortened and GOP has cut by 90% the funding to advertise these deadlines."

Also true, with a caveat. On Aug. 31, the Centers for Medicare & Medicaid Services announced it would allocate $10 million for its ACA promotional budget, down from $100 million in 2016. The agency claimed that despite doubling advertising funding from 2015 to 2016, "first-time enrollment [declined] by 42 percent," justifying the deep cuts.  

As for the caveat? Snopes didverify the information — though the claim that the "GOP" is responsible is not exactly right, as the adjustment was made by the Trump administration, not any particular political party.

"Administration is also taking the website down for 'maintenance' for 12 hrs at a time on weekends for most of the enrollment period when working people might most likely need to use it."

Again, true. In late September, the Department of Health and Human Services announced it would be taking Healthcare.gov offline on five Sundays during the open enrollment period, from 12 a.m. to 12 p.m.

Is the "congratulations" tactic an effective way to "hack" Facebook's mysterious algorithm?

Unfortunately, probably not. At least no more so than simply posting the information to Facebook without the "congratulations" attached.

The claim that including "congratulations" in a status boosts a post's ranking on Facebook comes from from a 2014 Wired article, which reported that Mark Zuckerberg proposed the idea himself, after noticing that a post about a colleague's birthday appeared higher on his own feed than a post about the birth of his own niece.

That's not the case today. A Facebook spokesperson said that including highlighted words like "congratulations" (which trigger delightful special effects when clicked) do nothing to improve a post's ranking on the news feed. He noted that posts that feature the word do "tend to get more engagement from people on the platform," which does increase their reach.

So should you post it yourself?

"Anything and everything is helpful in spreading the word," says Lori Lodes, co-founder of Get America Covered. A former director of communications at Centers for Medicare & Medicaid Services, Lodes was responsible for outreach efforts during Healthcare.gov's second and third open enrollment periods. Get America Covered was founded to fill the gaps left by the administration's cutbacks, in part by putting together resources to help individuals encourage those in their social networks to enroll.

In the meantime, Lodes supports sounding the alarm on Facebook.

"The most important thing people can do right now is to get the word out — whether that is talking to friends, sharing on social media or hanging up signs in their neighborhoods," she says.

The next few months will help determine whether the Affordable Care Act thrives or merely survives.

Can anyone really help replace the well-funded, coordinated effort of a large federal bureaucracy?

Photo by Joe Raedle/Getty Images.

That part remains to be seen. But it's up to you, regardless.

Congratulations!

Please copy and share?

On Thursday, actress Julia Louis-Dreyfus announced via Twitter that she had been diagnosed with breast cancer.

Just 11 days after accepting her sixth straight Emmy for Outstanding Lead Actress in a Comedy Series, the "Veep" star shared her diagnosis with the world.

"1 in 8 women get breast cancer. Today, I'm the one," she wrote.


"The good news is that I have the most glorious group of supportive and caring family and friends, and fantastic insurance through my union," she added. "The bad news is that not all women are so lucky, so let's fight all cancers and make universal health care a reality."

Each year, an estimated 231,840 U.S. women will be diagnosed with breast cancer, and more than 40,000 will die. Early detection plays a huge role in reducing that number.

Breast cancer accounts for the second-most cancer-related deaths in U.S. women behind only lung cancer, according to the American Cancer Society. Regular screenings — self-checks and with a doctor — can aid in catching the cancer at its most treatable point, early on.

In her call to action, Louis-Dreyfus sounds optimistic, urging her followers to keep fighting so that others have access to the same care she'll be able to receive. While recent efforts to repeal the Affordable Care Act have fallen flat, we are far from having "universal health care." 11% of women ages 19 to 64 in the U.S. don't have any form of health insurance. While that number has fallen since the ACA's implementation, it still means that millions of women are unable to access preventive care.

Thanks to a number of health centers around the country, such as Planned Parenthood, low-income and uninsured women aren't left completely out in the cold. Unfortunately, these groups are frequently under attack from political opponents.

Louis-Dreyfus's decision to share her diagnosis with her fans serves as a reminder that any of us can be hit by illness at any time — making the fight for universal care that much more important.

It's never a bad time to call your members of Congress and let them know that you want to live in a world where everybody has access to the same care she has.

We wish Louis-Dreyfus the absolute best of luck going forward.

Louis-Dreyfus accepts the Emmy for Outstanding Lead Actress in a Comedy Series on Sept. 17, 2017. Photo by Kevin Winter/Getty Images.

On July 25, 2017, as Congress' zillionth (or so it seemed) attempt to repeal and replace Obamacare was careening gently off a cliff into a bed of spikes, Sen. John McCain rose to the Senate floor and delivered a clarion call for bipartisanship.

"Let's trust each other," the maverick Republican legislator cried. "Let’s return to regular order. We’ve been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle."


Photo by Chip Somodevilla/Getty Images.

It was a stirring speech. A vital speech. A speech that, coming directly on the heels of McCain's vote to advance a bill that was being written by a group of Republicans in secret, seemed kind of like bullshit.

But now, not two months after the dust from the GOP's last, best shot at the law finally settled, it actually might be ... happening?

For the first time in seven years, Democrats and Republicans are trying to figure out how to patch up the Affordable Care Act. Together.

The result of the effort, if successful, would be the first major bipartisan change to the law since it was passed in 2010.

At least one Republican senator — Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander — is trying to make it happen by next week, according to the Washington Examiner.

OK, but just because it's bipartisan doesn't mean it's a good idea. What are they actually trying to do?

Photo by Joe Raedle/Getty Images.

Something very minor, but hey! Under the current law, the U.S. government pays health insurance companies to keep individual premiums down. President Trump has repeatedly threatened to stop these payments.

Alexander, Sen. Patty Murray, and others on the HELP Committee are trying to come up with a "stopgap" package that can continue the funding without having to rely on Trump, preventing premiums from spiking.

That sounds nice! But ... they must disagree on some stuff?

They sure do!

Alexander wants to roll back some of the ACA's essential health benefit requirements, which dictate what plans have to cover. Murray, meanwhile, hopes to properly fund reinsurance, in order to help insurers pay out claims to the sickest individuals.

They do, however, seem committed to reaching a deal.

Great, so everything's good now!

Not exactly. The same John McCain who righteously urged bipartisanship just two months ago? He just announced his support for a new "repeal and replace" bill that would "block grant" Medicaid to the states, potentially amounting to huge cuts to the program.

The Arizona senator told The Hill that, despite his earlier words, crafting the bill without Democratic input "doesn't mean I wouldn't vote for it." That doesn't just put the current bipartisan effort in jeopardy, but it potentially provides another last-ditch avenue to gut the law completely.

Still, for the first time in what feels like forever, it seems Congress might take July John McCain's advice and start working together again.

Sens. Patty Murray (D-Washington) and Lamar Alexander (R-Tennessee). Photo by Chip Somodevilla/Getty Images.

Working, that is, to try to make things better, not worse, for sick people.

Sound good to you? Give 'em a call and make sure they stick to it.

Fingers crossed, knock on wood, throw salt over your shoulder, punch a Komodo dragon they don't get any ideas from September John McCain.

Update 9/6/2017: McCain later clarified his position on the Graham-Cassidy proposal through a spokesperson, noting that while he endorses the "concept," he is waiting to see a bill before committing his support.