On July 11th, 2016, readers of the prestigious Journal of the American Medical Association (JAMA) were surprised to find that among the pages of research presented by doctors and biologists was an impact assessment of Obamacare written by the president himself.
The article, titled, “United States Healthcare Reform: Progress to Date and Next Steps,” makes the case that the Affordable Care Act (ACA), commonly referred to as Obamacare, has been beneficial for both insured and previously-uninsured Americans. Drawing on data from public sources such as the Centers for Disease Control (CDC) and National Center for Health Statistics, the president outlines the various strides the ACA has made in improving the health of Americans.
In the article, the President notes that the number of uninsured Americans has declined by 43% since the ACA was passed. This impact of this change cannot be understated.
The president also points to the improvements to health insurance and healthcare delivery that the ACA ensures for those who already had insurance. For instance, the law forbids insurance companies from dropping coverage for those who receive a serious diagnosis and also forbids insurance companies from refusing plans to those with preexisting conditions.
In addition, the ACA broadens insurance choice for healthcare consumers. Whereas many tax payers or employers had only one or two options when buying health insurance, now 88% of Americans live in counties that offer 3 or more insurance options. This means that insurance companies have to compete for the consumer’s business, which is important to Americas who have felt disempowered by their insurance companies.
Another important effect the ACA has had since its passing is that more Americans have caps on their out-of-pocket spending. This means that, come the worst diagnosis, there is an absolute limit to what a family will have to pay out-of-pocket for healthcare. In fact, in 2010, the year the ACA was passed, 82% of Americans had annual out-of-pocket limit. In 2016, nearly 97% of Americans have annual limits. Anyone who has a serious condition or accident can attest that not having an annual out-of-pocket limit can be catastrophic for families.
The bottom line is that there is plenty of evidence to show that Obamacare improves the health of Americans. That is what the president is trying to show in his JAMA article.
Of course, this is not a new assertion. The article repeats many of the same advantages we hear the President and Congressional Democrats make in speeches and press releases. These health data have also been published by health statistics organizations. This begs the question: why did the President choose a scholarly article to get this point across? Of course, we can only speculate what the president intended, but Howard Forman, Professor of Diagnostic Radiology, Public Health, and Economics at Yale, Director of Yale’s MD/MBA program and Director of University Healthcare Curriculum had a few ideas that he shared with The Politic.
“While the president could have had the article written by some organization, he may have felt that the buck stops with him and that he should author it himself. His name is associated with the law, so there’s a chance he feels more personally accountable to the outcomes of this law than others.”
But it may be even simpler than that, he says, “It may just appeal to him on a scholarly or intellectual level.”
Forman also notes that while it is unique for a president to publish scholarly works, it is not unique for lawyers to publish in medical journals or vice versa.
“JAMA publishes lawyers all the time. Some topics lend themselves more easily to crossover between disciplines.” Forman added, “There is more cooperation between doctors and lawyers than the public realizes. Forman, who advised the senate on health issues, would know.
In the age of easily-available information, more and more voters are asking, “Where is the evidence?” The president’s JAMA article draws evidence of Obamacare’s efficacy from many sources and compiles it in one accessible article.