If you’re like me — and I pray you’re not — your email inbox drowns every day with news about the ACA and health policy in every imaginable direction. Sometimes, two messages get juxtaposed next to each other in ways that illuminate a higher truth. I felt that way today.
First, came an email update from the Urban Institute and their Elevate the Debate project. Just look at these headlines, all based on newly released data:
- Insurance coverage gains cross economic, social, and geographic boundaries.
- 15 million adults have gained health insurance coverage since September 2013.
- The uninsurance rate for adults with chronic conditions has halved since September 2013.
- Gains in public coverage continue to outpace the loss of private coverage.
- The number of young uninsured has dropped, especially in Medicaid expansion states.
Big things, good news. I am especially impressed with the drop in uninsurance among adults with chronic health conditions such as diabetes, cardiovascular disease, hypertension, and asthma. Real progress and something to feel good about.
Then, the next email is from the Blue Cross Blue Shield Foundation of Massachusetts offers a wealth of new data on rising health insurance costs, especially deductibles and other cost sharing, confronting Massachusetts health consumers: Rising Health Care Costs in Massachusetts: What It Means for Consumers. What it means is not encouraging:
“The impact of these changes in health insurance products can be seen in spending trends, which show that by 2013, nearly one in ten adults spent over 10 percent of income on out-of-pocket health care costs. For an insured family of four with an income three times the federal poverty level (about $71,000 in 2013), that represents a burden of more than $7,000 per year over and above the cost of insurance premiums.”
Lots of progress and good news, and lots of discouraging trends as well. The the Blue Cross data only covers Massachusetts, the same trends are in evidence all over the nation, and worse in many other states. In the polarized craziness of the ACA, the news has to be all good or all bad, with no room for ambiguity or complexity. That’s not real and that’s not life.
The ACA is responsible for some of the most important gains in social and economic justice in our lifetime. And, we still have many vitally important gaps to close and gains yet to be made. That’s reality.