Good morning ... ugh.
President Obama signed the Affordable Care Act into law eight years ago today. It's been through an awful lot since then. And as much as this might sound like a contradiction, the ACA today is simultaneously far weaker than it looked in 2010 but also far more durable than it looked in the intervening years.
It’s diminished but basically working. For all the wounds it has absorbed — from Republican governors, Republicans in Congress and the courts, plus the self-inflicted ones — the ACA is still doing basically what it set out to do. Just not as well as it set out to do it.
It’s more popular than ever, but its core constituency is weak. The ACA is, and always has been, incredibly complicated, and that has made it a lot easier to treat the law as a political abstraction rather than a discrete set of policy choices.
Go deeper: The ACA is smaller, weaker and more liberal than Obama intended.
Americans say the cost of health care affects their finances more than the stock market, the job market or just about anything else, according to a new survey from the Pew Charitable Trusts. And though partisanship informs people’s views of how well the U.S. economy is doing, there’s a surprising across-the-board agreement that health care is front and center.
The numbers: 53% of the people Pew surveyed said health care affects their household budgets “a lot.” It was the only factor to crack 50% — just 21% said the same thing about the stock market.
Reality check: Health care accounts for about 8% of the average household’s annual spending — not as much as housing, transportation or food. But the grocery store never surprises you with a bill for several thousand dollars.
Most of the big recent hospital mergers have involved not-for-profit systems, like Advocate and Aurora, which got its final regulatory approval yesterday. But my colleague Bob Herman flagged a new transaction in the works that’s worthy of your attention, involving for-profit giant HCA Healthcare.
Go deeper: The health care arms race.
Prescription painkillers are the most frequently prescribed drugs in 10 states, and are among the top three to five most prescribed drugs in most of the country, according to new research from GoodRx.
Between the lines: Millions of people do suffer from chronic pain, and it's not at all fair to assume every one of these prescriptions would end in addiction. But, as much as it has spread into illegal drugs, a big part of this crisis still grew out of legitimate — or at least legal — prescriptions.
It's unlikely those prescribing numbers would remain so high if the crisis were getting better.
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