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Commentary By Oren Cass

No, Obamacare Has Not Saved American Lives

Health Affordable Care Act

The arguments of the law’s defenders don’t stand up to scrutiny.

Repealing the Affordable Care Act, Democrats say, will “make America sick again.” Bernie Sanders warns “36,000 people will die yearly as a result.” But as with most ACA defenses, these claims describe an imaginary health-care reform that works, not the legislation passed by Congress in 2010. In reality, the best statistical estimate of the number of lives saved each year by the ACA is zero.

Some studies do suggest that health insurance can saves lives. But these focus either on individuals with private coverage or on the Massachusetts health-care reform law of 2006, which primarily expanded private coverage within the Bay State. The ACA, by contrast, is primarily an expansion of Medicaid; in recent years, the share of Americans with private insurance has declined.

In 2007, just prior to the Great Recession, 66.8 percent of non-elderly Americans had private insurance. By 2015, two years into the ACA’s expansion, that share had declined to 65.6 percent. Taking the larger economic picture into account by looking back to 2007 is crucial, because the private-insurance rate fluctuates with employment. Between 2007 and 2010, employment fell by 5.5 percent and private coverage fell by 7 percent. Between 2010 and 2015, employment rose by 8.8 percent and private coverage rose by 9.5 percent.

ACA implementation has coincided with an increase in private coverage because it occurred during a period of job growth. But 300,000 fewer Americans have private coverage today than would have it if the ratio of coverage to employment had remained at its 2007–10 level over the last six years.

Instead, the ACA has increased insurance coverage by expanding Medicaid. In 2007, 18.1 percent of non-elderly Americans had public insurance. By 2010, that share was 22 percent, and rather than declining as the economy recovered, it continued to climb all the way to 25.3 percent in 2015.

This public-versus-private distinction is crucial, because studies of Medicaid do not find the same positive effects on mortality....

Read the entire piece here at National Review Online


Oren Cass is a senior fellow at the Manhattan Institute. Follow him on Twitter here.

This piece originally appeared in National Review Online