The IRA was also a health care bill

The number of Americans under 65 without health insurance has been cut nearly in half since the enactment of the ACA, and the expansion of tax credits in the Inflation Reduction Act is playing a role:

Enrollments under the Affordable Care Act have reached an all-time high on the federal and state exchanges, helping drive the nation’s uninsured rate down to record lows despite steeper monthly premium costs. 

The Biden administration Wednesday provided the most comprehensive look so far at sign-up activity during the ACA’s most recent open-enrollment period, which marks the 10th for the Obama-era health law. The official sign-up window on the federal exchange, HealthCare.gov, began in November 2022 and ended Jan. 15, although a number of states that run their own marketplace exchanges have later deadlines for 2023 coverage.

More than 16.3 million people selected a plan on the ACA marketplaces, based on data released Wednesday by the administration. Since President Biden took office, the number of people who have signed up for a plan through HealthCare.gov has grown by nearly 50%.

More than 1.8 million more people have signed up for ACA health insurance, or a 13% increase, from this time last year, the administration said, and 3.6 million people who selected plans were new to the marketplace rather than returning to renew coverage.

The rise in enrollments has helped lower the number of uninsured people under age 65, which fell to a record low of 8% in early 2022 from 10.5% in 2021 and 11.1% in 2019, according to the Department of Health and Human Services. In 2009, the year before the ACA was enacted, 17.5% of people under the age of 65 lacked insurance, according to the Centers for Disease Control and Prevention.

Note that the number of uninsured would be even lower had 1)John Roberts non re-written the ACA’s Medicaid expansion in a bizarrely illogical application of a doctrine that has not been applied before or since and 2)Republicans like Ron DeSantis were not willing to leave enormous amounts of money on the table out of their conviction that poor people should not have access to healthcare.

What are the Republican arguments against broadening access to healthcare?

Democrats say the robust enrollment is evidence the ACA is becoming an increasingly stable part of the U.S. health landscape after the Trump administration sought to undermine the law. 

Republicans and critics of the law say Democrats’ efforts to grow the ACA through more generous subsidies for consumers have made it an expensive program and a strain on the federal deficit. The federal government spent about $72 billion in 2022 for subsidies to lower premiums, according to projections by the Congressional Budget Office and the Joint Committee on Taxation. Spending had hovered around $58 billion in 2021.

“It is bad to spend money to get people medical treatment, when you could be using it for upper-class tax cuts.” That’s the whole argument. It’s a populist party now!