Obama’s Journal Article a First for Sitting President

(CN) — In a first for a sitting president, President Obama published a scholarly article in the prestigious Journal of the American Medical Association on the achievements thus far of the new health care law.

Titled "United States Health Care Reform: Progress to Date and Next Steps," the July 12 article provides the president an opportunity to defend his legacy, as most would agree that the Patient Protection and Affordable Care Act is by far the most important legislative achievement of his eight-year tenure.

"The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care," Obama wrote. "Since the Affordable Care Act became law, the uninsured rate has declined by 43 percent, from 16.0 percent in 2010 to 9.1 percent in 2015, primarily because of the law's reforms."

The eight-page study includes 68 footnotes to academic journals and government publications.

Obama presented evidence that the number of Americans without health insurance has dropped dramatically since the implementation of the 2010 Affordable Care Act, which has also resulted in lower hospital readmission rates.

Since 1990, the nation's uninsured population had hovered around 15 percent, according to data derived from the National Health Interview Survey, cited in the article.

That level steeply declined to under 10 percent in the last six years due to the ACA's reforms.

Obama also pointed out the greater percentage decline in the adult uninsured rate in states that decided to expand their Medicaid programs as made possible by ACA funding.

"Greater insurance coverage appears to have been achieved without negative effects on the labor market, despite widespread predictions that the law would be a 'job killer,'" Obama said. There is also evidence that the law has slowed the rate of growing health care costs.

In the article, the president advises his successor to build on the law's progress. Hillary Clinton, if elected president, has promised to do just that. Donald Trump, however, has vowed to repeal the law.

"Too many Americans still strain to pay for their physician visits and prescriptions, cover their deductibles, or pay their monthly insurance bills; struggle to navigate a complex, sometimes bewildering system; and remain uninsured," Obama wrote.

He lamented that 19 states have yet to expand coverage for their citizens via Medicaid, which has left four million Americans uninsured. He also regrets that a Medicare-like public option did not make it into the final bill.

"Based on experience with the ACA, I think Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited. Adding a public plan in such areas would strengthen the Marketplace approach, giving consumers more affordable options while also creating savings for the federal government," the president wrote.

He closed by criticizing Republicans for working tirelessly to undermine implementation of the ACA, warning the nation that special interests in the health care industry continue to oppose change.

"We worked successfully with some health care organizations and groups, such as major hospital associations, to redirect excessive Medicare payments to federal subsidies for the uninsured," Obama said. "Yet others, like the pharmaceutical industry, oppose any change to drug pricing, no matter how justifiable and modest, because they believe it threatens their profits. We need to continue to tackle special interest dollars in politics."

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