On Friday evening in Ottawa, President Barack Obama told the capacity crowd at the Canadian Tire Centre that, under the Affordable Care Act (Obamacare), 20 million more Americans received access to health care insurance. Obama believes that this is one of the accomplishments of his Presidency that has had the greatest impact on America and Americans. But what exactly is the impact of giving 20 million more Americans access to health insurance, and who are some of these Americans?

The biggest impact of the Affordable Care Act is arguably the savings that will be realized to the government because providing health care to more individuals has slowed considerably the rate at which health care costs increase. This article reports that the increase in health care costs was 4% during 2004 and had decreased to 1.2% for 2016 after the Affordable Care Act became the law. The reason for this change is related to disease prevention because of having good medical care.

The Affordable Care Act aligns with the World Health Organization’s (WHO) work to promote Universal Health Care in all countries. The WHO monitors progress toward Universal Health Care by tracking 2 parameters:
1. The proportion of the population that can access a specific set of 16 essential health services.
2. The proportion of the population that must spend a large amount of household income to have access to these essential services.

The 16 essential health services include reproductive and maternal, newborn and child health; certain measures to treat and prevent infectious diseases; measures to prevent the noncommunicable diseases that are have the greatest impact on health; and access to certain high impact services. The complete list can be reviewed on the WHO website. If you compare this list with the 10 essential benefits of Obamacare, you will find that the two lists overlap. The Affordable Care Act has given 20 million Americans access to Universal Health Care, as recommended by the World Health Organization, that they did not have previously.

One of the measures of the Act is that children can now remain on their parents’ insurance plans up to age 26. This alone gave 3 million more young people access to health insurance. The benefits of prevention will be even greater in this population since the disease risk over their lifetimes will decrease because of improved preventative health care.

Another group benefitting from the Act is the middle class. Which persons and families fit in to the middle class is not always easy to determine, since such factors as the cost of living differ greatly from one community to another and most of the accepted definitions for middle class take this into account. President Obama’s policy was based on a middle class in which an individual income was less than $200,000 and a couple’s income was less than $250,000. Given the cost of living in most mid to large American cities, it’s not hard to see how this is the case. Under Obamacare, middle class adults without children got access to health insurance for the first time.

Aside from the numbers that demonstrate that the additional health care coverage provided by the Affordable Care Act was a good financial decision for America and Americans, I listened to President Obama speak about this accomplishment as a physician who often has to refer patients for a treatment that is very difficult to access: Cognitive Behaviour Therapy (CBT). While a youth can have access to CBT sessions in my program, the wait lists for this service for youth over 18 in my community are too long to be conscionable. Also, some of the more specialized psychotherapies are not available at all, except privately. It is agonizing for youth, families and clinicians not to be able to provide care. It is not only agonizing. People can die. We can all relate to what it must feel like not to be able to access basic care: like prenatal care when you’re pregnant, or check-ups for your children, or emergency services when you’ve had an accident.

Obamacare changed all that for 20 million Americans. That’s quite a legacy, and it will have positive consequences for Americans forever.

(This is an image of President Barack Obama signing the Affordable Care Act. Photo credit)

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