President Barack Obama’s first term was defined by the battle over, and the passage of, the Patient Protection and Affordable Care Act, the landmark health-reform legislation known popularly as Obamacare. Along the way, Obama, the law’s supporters, and independent analysts such as the Congressional Budget Office (CBO) made specific claims or projections about how the law would affect consumers, patients, and businesses.
Now, three years after Obamacare’s passage, many key provisions of the legislation are beginning to be implemented. Whether implementation succeeds or fails will be strongly influenced by the reactions of states, providers, insurers, businesses, and consumers to the law’s provisions and to the thousands of pages of new health-care regulations.
Rhetoric and Reality is a project of the Manhattan Institute’s Center for Medical Progress designed to offer an ongoing, objective, and accessible perspective on the law’s performance in light of key claims or projections made about it. Our project will examine the law’s effect on Americans in five overarching areas: health-care costs, insurance coverage, employment, access to care, and consumer-driven health plans. Additional topics may be added.
Each evaluation will be based on the best available data and will be revised as new or more authoritative data become available. Each evaluation will come with a letter “grade” on the law’s performance, using the following scale:
A = Very strong likelihood that the reforms will achieve their intended goals
B = Moderate evidence that the reforms will achieve their intended goals but a need for future analysis
C = Weak evidence that reforms will achieve their intended goals or growing evidence of unintended
D = Little or no evidence that the reforms will achieve their intended goals and significant evidence of unintended consequences
F = Undeniable evidence that the reforms will produce effects contrary to their intended goals
I (Incomplete) = Insufficient evidence to support a final judgment on the effects of the reforms