The Affordable Care Act, the most sweeping health care program created in a half century, is expected to extend coverage to 25 million Americans over the next decade, according to the most recent government estimates. But that will still leave a projected 31 million people without insurance by 2023. Those left out include undocumented workers and poor people living in the 21 states, such as Virginia, that have so far declined to expand Medicaid under the statute, commonly called Obamacare.“The law will cut the number of the uninsured in half,” said Matthew Buettgens of the Urban Institute. “This is an important development, but it certainly isn’t the definition of universal.”
This is not the first time Wonkblog has run a post on Obamacare’s lingering uninsured (see here, e.g.) Obamacare’s failure to cover everyone is seemingly the only ACA failure its supporters are comfortable talking about. We’ve noted before that for those who support a public option or a single payer system, some Obamacare’s flaws are actually features, not bugs. If the ACA both succeeds and fails in the right kinds of ways—if it lowers prices, but doesn’t fully expand access—these wonks believe they can make a case for supplementing Obamacare’s reform with even more government regulation and control. Obamacare worked and now we just need more of it.Expect left-of-center health care writers to more and more ask “what’s next?” and execute the single-payer pivot as the answer.