It’s been a good couple of weeks for the Affordable Care Act. Having survived what might well have been a mortal threat with a favorable ruling from the Supreme Court in the King v. Burwell case, the Obama administration’s signature legislative achievement got some more good news on Friday when the Gallup polling organization reported that the percentage of Americans lacking health insurance has hit the lowest level it has ever measured.
The new finding shows that uninsured Americans now represent 11.4 percent of the population, down from 18 percent in late 2013, just before the law’s coverage requirements went into effect. Gallup and its partner Healthways interview 500 people per day for the ongoing survey, and the results reported Friday represent the aggregation of some 44,000 responses taken in during the second quarter of the year.
The next question for those tracking the effectiveness of the law is how far the rate can reasonably be expected to fall. Many millions of people are currently without coverage because a number of states have refused to accept the Medicaid expansion that the law offers. But those individuals do not make up the entire pool of uninsured people.
While Gallup predicted that the rate will continue to decline, it will likely do so on a much flatter trajectory.
“Enrollment for 2016 coverage begins Nov. 1, 2015,” wrote Gallup’s Stephanie Kafka. “The uninsured rate may decline again slightly, although less significantly than it did over this past year, as those who remain uninsured are likely the hardest to engage.”
Perhaps buoyed by the recent spate of good news, the administration on Friday revived one of the elements of its health care reform agenda that, for entirely bogus reasons, stirred massive controversy: a plan to allow Medicare to compensate physicians for discussing living wills, advanced directives, and other end-of-life-related healthcare issues.
In 2009, former Republican vice presidential candidate Sarah Palin coined the term “death panels” for the service, suggesting that the administration was setting up boards of faceless bureaucrats to decide who would receive live-saving medical treatment and who would be left to die.
Though it was utterly unrepresentative of what the law said, and was immediately called out as a lie by fact-checkers, conservative media outlets ran with the idea and reported it, sometimes breathlessly, as a serious issue. By 2010, by one estimate, some 30 percent of Americans believed that “death panels” had actually been proposed by the Obama Administration.
The plan was shelved until this week when, as part of a large overhaul of its system for compensating physicians, the Centers for Medicare & Medicaid Services proposed new rules covering “advance care planning.”
The plan, according to CMA, is “consistent with recommendations from the American Medical Association (AMA) and a wide array of stakeholders” and “includes early conversations between patients and their practitioners, both before an illness progresses and during the course of treatment, to decide on the type of care that is right for them.”
There doesn’t seem to be much likelihood of blowback from the GOP Congress over the proposal. But there are still some who refuse to let the death panel myth die.
The announcement prompted a lengthy Facebook rant from Sarah Palin. “Government needs to stay the hell out of our ‘end-of-life’ discussions. I'm so angry at democrat and republican politicians who just rolled their eyes when I, and many others, rose up with warnings that each step forward taken by champions of this socialist program would jerk back two steps from every free American and our God-given rights.”
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