jim hancock: You Break It; You Buy It

Saturday, October 04, 2025

You Break It; You Buy It

Here’s the thing….

It’s not the only thing … we’ll get to other things … but this is definitely an important thing because it goes straight to our collective capacity to tell facts from fictions and truth from lies.

It's about the Patient Protection and Affordable Care Act of 2010, also know as the Affordable Care Act, Obamacare, and ACA.

On the merits...

The Affordable Care Act began to strengthen the overall economy right out of the gate — by expanding the number of Americans with health coverage, by helping to stabilize the growth of health spending, and by improving financial security for millions of Americans in income brackets that plow every paycheck back into the real economy.

The ACA did *not* reduce overall economic growth or increase unemployment

In fact, a series of Commonwealth Fund reports identified significant private sector job growth, and a slowing of per capita health care spending growth. In real time, the ACA boosted U.S. economic growth in a period when the developed global economy struggled to recover from the Great Recession.

The ACA generated measurable job mobility and entrepreneurial activity

The ACA banned insurers from denying coverage based on preexisting conditions. Which meant no one needed to stay in a job because they needed the insurance. Which meant they could move to better jobs, however they defined *better*. Which meant more entrepreneurs could start new ventures without the added risk of being uninsured. It also meant people could retire early if they wanted to. Which meant younger workers could advance sooner. All of which added to U.S. productivity and innovation.

By slowing the growth of health care costs, the ACA improved both the business climate and the cost of governance

Slower insurance premium growth freed up business resources for investment in production and jobs.

Slower growth in overall health spending contributed to lower federal budget deficits.

Cost containment helped stabilize state and local government budgets.

Here's the rub: Americans in states that chose not to participate fully in the ACA missed out on many of these benefits

To be crystal clear, these benefits were *not* withheld from those Americans by the federal government; their legislators and governors decided to refuse them.

Americans in ACA states saw decreased premiums and more improved coverage that those in others states.

The knock-on effects of improved minimum standards of coverage and care meant higher premiums in states that opted out than those that fully embraced ACA benefits and protections.

ACA states added hundreds of thousands of related jobs; the others did not.

ACA states realized significant reductions in losses from uncompensated care; the others did not.

Hospitals and clinics in small towns and rural counties were significantly more likely to survive and thrive in ACA states than those who took a pass on the Patient Protection and Affordable Care Act

Medicaid enrollees in ACA states have benefited from reductions in income inequality, evictions, bankruptcies, and improvements in credit scores that citizens in other states did not.

So riddle me this....

15 years after demonstrating the benefits of the Affordable Care Act at the household level and across the U.S. economy, why would Banana Republicans keep doubling down on hurting people they swore to help?