Is Obamacare working?

Way back last fall, when HealthCare.gov was so dysfunctional we advised people to stay away while it was being repaired, few people imagined that the new health law could possibly meet its informal target of signing up 7 million people for private health insurance during the first open enrollment period.

But it did, and then some. This week President Obama unveiled the final open enrollment tally, and it was impressive:

• 8 million people enrolled in private insurance through their state’s Health Insurance Marketplace.

• Another 5 million enrolled in new plans sold outside the marketplace that meet the health law’s higher standards.

• Medicaid and CHIP enrollment increased by 3 million (and by the way, you can enroll in these programs year-round).

• And an estimated 3 million young adults avoided going uninsured by being allowed to stay on their parents’ plans.

Numbers like those are big enough to affect the uninsurance rate in the United States, and they have, according to the latest Gallup Poll. As you can see on the chart above, the percentage of Americans lacking health insurance is the lowest it’s been in more than five years.

Moreover, according to the nonpartisan wonks at the Congressional Budget Office, lower-than-expected health cost growth means that the price tag for expanding coverage under the new law will be $104 billion less than originally projected over the next 10 years, and the Medicare and Medicaid will cost $180 billion less by 2020 than originally projected in 2010.

As the saying goes, this is a win-win: more people covered, costs lower than we thought.

But one piece of health reform news is not good: the decision by 24 states not to expand the Medicaid program to cover all low-income households has left 5.7 million people without a source of health coverage they can afford.

What this means is that the new law is working way better in states that embraced it than in states that resisted. The Gallup analysts looked at the change in insurance in the 21 states that went all out for Obamacare by expanding Medicaid as well as operating their own marketplaces rather than leaving the job to HealthCare.gov. In those states the proportion of uninsured residents fell 2.5 percentage points, from 16.1 percent in 2013 to 13.6 percent today. But in the other 29 states, the uninsured rate fell only 0.8 percentage points, from 18.7 percent in 2013 to 17.9 percent today.

Here’s the honor roll of the 21 states that helped their inhabitants get insured by fully embracing the new law: Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, and West Virginia.

If you live elsewhere, ask your elected officials why they think it's okay to try to keep people from getting health insurance easily and affordably.

Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can't get enough health insurance news here, follow me on Twitter @NancyMetcalf.

—Nancy Metcalf

We're providing regular coverage of the new health care law. To get health insurance advice tailored to your situation, use our Health Law Helper, below.

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