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The debate is on as to whether the Patient Protection and Affordable Care Act, also known as “Obamacare” is in full swing.  This is a difficult question because it partially depends on your interpretation of “healthcare”.  People tend to use healthcare and health insurance synonymously.  In reality, healthcare is the treatment you receive from a doctor or hospital, health insurance is product you own that helps you pay for health care.  We should take some time to explore both of these.

The uninsured rate has gone down since the passage of the Affordable Care Act, There are several factors to consider here.  Some are due to the Law and some the economy.  Since the majority of Americans get their health insurance through their job, it stands to reason that when the economy picks ups and the unemployment rate shrinks, so will the uninsured rate. In the law there is a provision that children can stay on their parents’ policies until their 26th birthday.  That is an age bracket that often went uninsured so that is a benefit for that age bracket.  Prior to the law, many States allowed this benefit to full-time students only.  Now, those young adults, do not even need to live in the same house as their parents. The Affordable Care Act also expanded Medicaid.  It was left up to the states if they wanted to participate in that portion of the program  thirty one  states expanded Medicaid.  Medicaid is a government run program for lower income families.  Some will argue that this is not insurance.  It is a medical card provided by the state.  This benefit can be lost depending on income.  None the less, people can see a doctor or a hospital with this benefit.

Having Health insurance, whether it be through the insurance marketplace, an  employer or Medicaid, does not necessarily mean you have easy access to health care.  Many doctors have stopped taking Medicaid patients since the reimbursements are lower than traditional health insurance.  Many insurance plans have narrowed their network of doctors and hospitals to try to reduce premiums.  They have been able to negotiate with a small number of medical providers to control their costs.  There are also some medical groups that have decided it was not in their best interest to accept certain insurance networks due to the reimbursement levels.  So even though more people may have insurance benefits under “Obamacare”, it is highly possible that doctors and hospitals may no longer service the patients who had previously been under their care.

The State of Oregon began expanding Medicaid back in 2008.  Oregon conducted a study for people who could qualify for Medicaid who were previously uninsured.  The study cited, in The New England Journal of Medicine, after two years of  examining patients with high blood pressure, elevated cholesterol and diabetes, found no statistically significant impact of having