Meanwhile, back in the world in which smart, forward-looking public policy actually makes a difference in people's lives, an Urban Institute study shows the positive results in Obamacare's first two years—just in Medicaid expansion.
The uninsured rate for poor, childless adult citizens in Medicaid expansion states fell from 45.4 percent in 2013 to 16.5 percent in 2015, a decline of 28.9 percentage points.
• After adjusting for observed changes in non-expansion states and differences in population characteristics between expansion and non-expansion states, we find that the ACA Medicaid expansion reduced the uninsured rate for poor, childless adult citizens in Medicaid expansion states by 21.4 percentage points between 2013 and 2015. This reflects a 47.1 percent decline from the 2013 uninsured rate of 45.4 percent.
• Large coverage gains, ranging from 18 to 26 percentage points, were found for all subgroups of childless adults by age, sex, race, income, and education. Some subgroups experienced relative declines in uninsurance of 50 percent or more.
• Among childless adults in fair or poor health, the ACA Medicaid expansion reduced the uninsured rate by 21.2 percentage points, or 61.7 percent, compared with the pre-ACA level.
• By 2015, uninsured rates were near or below 20 percent for all subgroups of childless adults in expansion states; uninsured rates were over 40 percent for all subgroups in non-expansion states. […]
Notably, childless adults in fair or poor health saw their uninsured rate decline by 61.7 percent under the ACA Medicaid expansion. These strong coverage gains among people with health problems suggest that the ACA Medicaid expansion reached a group of vulnerable adults who likely had limited access to affordable coverage before the ACA.
An almost-30 percent decline in uninsured rates is huge. It's massive. It's life-changing for that demographic which remains shut out of coverage in the non-expansion states. This is the population that Republicans believe should be left out—the "able-bodied" who should be out there working, which totally ignores the fact that this group works: "62 percent are already working or in school and 12 percent are looking for work; only 25 percent are not currently working or in school."
In a sane world, this would be great news. This would be smart policy that every state would want to duplicate. In this world, however, the Republicans who control the Congress, the White House, and too many state legislatures believe this is bad, for whatever reason. Mostly because it came with Obamacare, but also because they don't believe in government helping to lift up its citizens. At least, not the ones who aren't already rich or powerful.