One thing that really bothers me is the number of people claiming that the Affordable Care Act will bring “universal health care” to the United States. Ryan Lizza’s makes this claim in his defense of President Obama at the end of his long story in the New Yorker, but he simply the most recent example of this far too common inaccurate statement. From Ryan Lizza:
Obama didn’t remake Washington. But his first two years stand as one of the most successful legislative periods in modern history. Among other achievements, he has saved the economy from depression, passed universal health care, and reformed Wall Street. Along the way, Obama may have changed his mind about his 2008 critique of Hillary Clinton. “Working the system, not changing it” and being “consumed with beating” Republicans “rather than unifying the country and building consensus to get things done” do not seem like such bad strategies for success after all.
Let’s leave aside the issue that health insurance doesn’t necessarily mean health care. Care can still be too unaffordable or unavailable even when one has something called health insurance.
The ACA will not result in universal health insurance in America. According to the CBO and CMS even after being fully implemented there will be 23 million people in the country without insurance. In 2019 if the law is implemented 93.1 percent of the people in country are projected to be insured. That is significantly higher that the 83 percent that would be insured without the ACA but 93.1 percent is by no definition universal. To achieve universal health insurance that would require another expansion of coverage almost as large as the one that is expected to be produced by the ACA.
It is very possible to achieve effectively universal health insurance, but this law isn’t projected to do that. The adoption of different health care policies, such as single payer, could push the percent dramatically closer to 100 percent.
You can call the ACA many things, health insurance reform, a large coverage expansion, even “near universal” health insurance; but it is simply not universal health care. That is factually inaccurate and more important hides the fact that as a country will still significantly policy issues regarding coverage and access in the future.