The Affordable Care Act (ACA) most definitely caused a huge political divide in Washington D.C. But since ACA passed, how is it affecting Detroit, MI? First let’s go over the background story.
The ACA (also known as Obamacare) is a set of laws. When these laws are bunched up together, they aim to increase the number of insured individuals and decrease the cost of healthcare delivery. One of the pinnacles of Obamacare is “Medicaid expansion“. A quick explanation: if someone’s income falls below the poverty level ($23,850 for a family of 4, and a little over $11,000 for one person), then his or her healthcare costs can be covered by their state. With Obamacare’s Medicaid expansion, this coverage is extended to those who fall 133% below the poverty level. Cool? Yes, but the big question is: where is the money to cover all those extra people coming from? The federal government hence agreed to cover the cost of Medicaid expansion for states that agree to adopt it, at least for the upcoming few years. I don’t know what’s going to happen after that.
The NY Times published an article in October 2014 showing how the number of insured individuals changed since Obamacare. Data came from Enroll America (TM); an organization that works on increasing the number of insured Americans as well as Civis Analytics. Take a look at this self-explanatory graphic:
As published on the NY Times:
[The law] has pushed back against inequality, essentially redistributing income — in the form of health insurance or insurance subsidies — to many of the groups that have fared poorly over the last few decades.
The biggest winners from the law include people between the ages of 18 and 34; blacks; Hispanics; and people who live in rural areas.
States like Maine and many southern states rejected Medicaid expansion (Arkansas is a notable exception, a little lighter hue on the map), but still saw some reduction in the percentage of uninsured individuals. Click here for an interactive map.
How about Detroit? Wayne county, where Detroit is, had a estimated reduction of 9% in the number of uninsured individuals. It’s that dark outlier in Southeast Michigan on the map.
So what’s the effect on the residents, fellows, and attending physicians locally? Are we seeing more patients in clinic now? How about floor? I don’t know the answer to that, but one thing is for sure; we have to look at data first.