Fact Check: The truth behind the Affordable Care Act

Donald Trump has launched a fresh attack against the Affordable Care Act, reaffirming his commitment to scrapping the healthcare plan introduced by his predecessor.

The legislation, commonly known as Obamacare, has been repeatedly branded a failure by the Trump administration and other senior Republicans, but is that a fair assessment?

Who says what?

Subscribe to The Week

Escape your echo chamber. Get the facts behind the news, plus analysis from multiple perspectives.

SUBSCRIBE & SAVE

Sign up for The Week's Free Newsletters

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

Sign up

Speaking at a meeting of the nation's governors at the White House yesterday, Trump said there was "nothing to love" about Obamacare. "It's a disaster, folks."

Critics have also repeatedly claimed that the legislation has led to large premium hikes. "We know that things are only getting worse under Obamacare," House Speaker Paul Ryan has said. "This is about people paying higher premiums every year and feeling powerless to stop it."

Democrats have vowed to fight the plans, saying lives will be put at risk if Obamacare is repealed. "We are not going back. Understand that," House Minority Leader Nancy Pelosi said last month. "They want to go from affordable care to chaos. We are not going to let that happen."

Trump is also under growing pressure from his own party to offer specific details about his plans to repeal the law during his first speech to a joint session of Congress tonight.

What are the facts?

Since it was enacted in 2010, the Affordable Care Act has expanded health coverage to 20 million Americans, a figure Trump's team has not disputed. The legislation has also meant millions are no longer at risk of being denied coverage due to pre-existing conditions, according to Politifact.

"This includes people covered through the law's expansion of Medicaid, the creation of the Health Insurance Marketplace, and changes in private insurance," the fact-checking website reports.

Figures from the Centers for Disease Control show that the uninsured rate for non-elderly adults fell to an all-time low of 8.9 per cent in 2016, down from 16 per cent in 2010. "[This] decline was especially pronounced among lower-income Americans," says the Los Angeles Times.

But it hasn't been all good news. "Obamacare is failing to deliver on the promise of bringing competition to the individual marketplace," says Vox. Premiums are also predicted to rise sharply in some parts of the country this year, according to analysis by the Kaiser Family Foundation. But experts note that subsidies will protect some customers from these increases.

Who is right?

Despite rising premium costs for some customers – which Ryan is right to acknowledge – Republicans cannot dismiss Obamacare as a complete failure. It achieved its goal of extending coverage to millions of lower-income Americans who could not previously afford health insurance.

Experts suggest that lawmakers on both sides of the aisle should be cautious when discussing Obamacare. "Democrats, too, are guilty of rhetorical excesses around the health care law, often claiming that it's working as intended while downplaying its flaws," the Associated Press reports.