I had a remarkable interview with North Dakota Insurance Commissioner Jon Godfread this past week.
During a segment on my radio show, I asked Godfread if he'd be willing to go back to the time before Obamacare.
"I would," he told me.
The Patient Protection and Affordable Care Act was supposed to increase competition among insurance companies while lowering premiums on the way to lower uninsured rates.
Have those things been accomplished in North Dakota?
Godfread says no.
He says prior to Obamacare our state had 13 insurance companies offering various health insurance products. At that time we also had an uninsured rate of about 12 percent.
After Obamacare? We now have just three companies offering health insurance products, and the uninsured rate remains at about 12 percent.
"I don't know what we've gained," Godfread told me.
Obamacare supporters usually choose this point in any discussion about health care policy to start talking about how people with pre-existing conditions can now get coverage. They talk about popular new mandates such as "children" staying on their parents policy until deep into their 20s.
But those provisions were about expanded access to coverage. If that access has truly been expanded, why haven't we seen more change in the uninsured rates?
Maybe there has been more change in other parts of the country — how could there not be when the government is mandating the purchase of coverage — but here in North Dakota there has been little in the way of gains.
What changes North Dakotans have seen have mostly been painful. There's the ceaseless political turmoil and health care policy, for one thing. Plus purchasing insurance has, for many North Dakotans, become both more complicated and far more expensive.
During our interview, a listener who works as a farmer emailed in this anecdote:
"I'm in the ND minority population that buys individual plans but doesn't qualify for tax incentives. We have a healthy family of six. Pre-Obamacare the policy was $895/month with a $2400 family deductible before anything was paid. Today for a policy it is $1800/month with a $4800 deductible."
The listener went on to describe how his family has absorbed that new expense by cutting back on eating out, vacations, and charitable giving.
This is not an uncommon story.
Obamacare supporters like to talk about the people the law has supposedly helped. But what about the people it has hurt, in very real ways?
I don't think any rational person, not blinkered by partisan politics, can argue that Obamacare has achieved its goals. Insurance really isn't any more accessible today than it was before. In some ways it's far less accessible, and there are few choices in the market to boot.
Republicans, who have campaigned for years on repealing and replacing Obamacare, haven't been able to get that job done. Mostly because they can't agree on what should replace it.
Maybe they should just focus on the repeal. It wouldn't be perfect, but it would be better.