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Monday, November 11, 2024

Why Harris Lost

Many others have offered myriad explanations for how Trump defeated Harris. Some think Harris lost because she didn't appeal enough to women. Some argue that Biden stayed in the race too long, and it doomed Harris because she didn't have enough time to win. Some say it was trans issues. Some say it was inflation. Some even say that Trump voters were duped by a disinformation bubble.

Here are a couple rundowns of reasons from Vox and AEI. I find this explanation closest to my own view, and below, I explain it more comprehensively.

I'm a long-time proponent of the median voter theorem. The concept is more simple than the name. The idea basically is that to win an election, a candidate needs to win a majority of the votes, and to win the majority of the votes, that candidate has to win the vote of the median voter--the voter exactly in the political center of all voters. The candidate who wins that voter, generally by staking positions closest to them, wins the election.

The story of 2020-2024 is that in 2019 Harris was pretty far to the left, and lost the primary. Biden was pretty close to the center and won it. In the general election, he campaigned as a perfect centrist. However, once he became president, he shifted to the left and stayed there. When Harris took over, she moved up to, but not beyond where Biden governed, which left Trump much closer to the center than Harris, so Trump won.

In 2020, Joe Biden ran as a moderate

The 2020 Democratic primary featured candidates spanning the entire Democratic party, from Sanders and Warren representing the far-left to Biden, Buttigieg, and Klobuchar representing less far-left. And of them, Biden had the most experience, name recognition, and political power.

Once he won the nomination, he campaigned on ending the pandemic, but never said how. He was ambiguous on fracking. He thought Trump's immigration restrictions were too restrictive.

The Brookings Institute: "Joe Biden appealed to the center of the electorate across party lines. He did 10 points better than Hillary Clinton among Independents, and he doubled her showing among moderate and liberal Republicans...If the Democratic Party is regarded as going beyond what the center of the electorate expects and wants, Democrats' gains...could evaporate."

The BBC: "Biden stuck with a centrist strategy, refusing to back universal government-run healthcare, free college education, or a wealth tax. This allowed him maximise his appeal to moderates and disaffected Republicans during the general election campaign."

Biden won independents by 9 points--52 to 43, when Clinton had only won them by 1 point in 2016.

Joe Biden barely won his election

Even with all the benefits of running against one of the most singularly despised candidates in decades, a pandemic roiling the economy and the culture, civil unrest, record-setting fundraising, Biden only barely defeated Trump in the electoral college. Biden won three states by less than 1% of the vote--Georgia (0.23%), Arizona (0.30%), and Wisconsin (0.63%). Combined, Trump lost by a total 42,918 votes.1

Votes are still being counted in the 2024 election, but at the moment, Harris's easiest path would have needed to swing Pennsylvania, Michigan, and Wisconsin to have won the election. She would need to swing 255,000 votes. The differences in margin are 1.2% (PA), 1.4% (MI), and 0.8% (WI). Not quite as close as 2020.

Biden Moved Left

Once in office, President Biden swiftly moved left. He issued executive orders "at a record pace," signing more executive orders in his two days than any other president signed in his first 30. His executive orders were not just undoing President Trump's work, or meant to address the pandemic, but showed that he was "taking steps Democrats have long demanded on immigration, the environment and racial justice."

In his initial flurry of executive actions, Biden required masks on federal property, extended foreclosure and eviction moratoriums, froze student debt collection, revoked the permit for the Keystone Pipeline, cancelled other energy rules created under the Trump administration, and pulled back on immigration enforcement. While many of these were demanded by Democrats, even the ones that were arguably centrist positions at the time, came to represent a immoderate president.

In February, Biden indicated he was more beholden to the teachers' unions than science when he waffled on re-opening schools. The head of the CDC, Rochelle Walensky indicated it was safe to re-open schools, but teachers unions scoffed, and the Biden administration fell in line and called for more funds before they could re-open.

In March, Joe Biden nominated Lina Khan to be an FTC Commissioner, notably, not the chair. Lina Khan was notable for writing a very famous article calling into question the application of anti-trust law to the current slate of American tech companies, most prominently Amazon, because they served as platforms that gave their products away for free, so the conventional approach of using price increases to prevent monopolies wasn't reliable.

She went on to work for other Democrats, and was considered a talented but pretty far-left expert on anti-trust in the digital age. Many Senators thought being a commissioner was acceptable given it was the President's prerogative, and the FTC could have three Democrat-appointed commissioners. One of them being more progressive was unobjectionable. However, immediately after she was confirmed with bipartisan support, she won confirmation in a 69 to 28 bipartisan vote, President Biden named her the chair of the FTC.

"Her appointment was a victory for progressive activists" according to the New York Times and was "hailed by many Democratic lawmakers." Elizabeth Warren said "With Chair Khan at the helm, we have a huge opportunity to make big, structural change..." The Vice President of NetChoice said she would make the independent agency more political. In office only briefly, she embarked on a aggressive agenda to push the FTC firmly in the progressive direction.

This episode symbolized Biden's move from moderate campaigner to aggressively progressive president. No one expected he would put Lina Khan in change of the FTC, even when she was nominated for commissioner. The change was a shock not only because it was unexpected, but it was unprecedented for a President to have misled Senators and the public on his intentions. In addition, while the business world had strongly supported Biden's campaign, their support of him surely wavered with such an anti-business Democrat put in charge of the FTC.

These are just two early-on instances of his lurch to the left, especially as compared to how he campaigned. There were many more. There was Merrick Garland going after parents who were concerned about what their kids were being taught, labelling them as terrorists; there was the student debt relief which he had avoided during his campaign and steered clear of, but then decided to pursue unilaterally despite previous arguments that it was unconstitutional. He tried to require masks on planes and vaccines for workers. Both of which failed in court. Both of which he continued to pursue despite their unpopularity. He always sided with unions and decided he'd be the first president to stand in a picket line. He discontinued natural gas exports. He tried to apply the protections in Title IX, which was meant to prevent discrimination based on a person's sex, to trans students. Biden also moved to aggressively reduce the number of gas-powered cars and replace them with EVs and his administration briefly contemplated banning gas stoves before it went public.

Biden was so committed to not enforcing the border, he wouldn't enforce his vaccine mandate for illegal immigrants even though he did for travelers. He flew illegal immigrants all over the country though he did his best to keep it quiet. He created an app so that illegal immigrants could bypass the border altogether and schedule their entry via airplane. Lastly, when there was a misunderstood photo of the border patrol and a border crosser, he immediately sided with the immigrant and never apologized for his mistake.

Also remember that the Build, Back, Better agenda was originally another multi-trillion dollar package for which many Democrats tried to expand the definition of infrastructure to include their economic agenda.

The result of all of these individual items and moves was that Biden was perceived by many, on the left, and the right, and the center, to be the most left-wing president of the last fifty years. People compared him to FDR and he basked in it.

Biden's Approval Rating Suffered

Source: 538

The other, more significant, consequence of Biden's policy portfolio was an approval rating that danced around 40% for most of his presidency. It's well-known, that his approval rating plummeted after the botched Afghanistan withdrawal. It reached its lowest point in July of 2022, almost a year later, and just before the Chips and IRA bills passed in August. He enjoyed about six months of approval in the low 40s, before it started dropping again. From December 2023 up until his disastrous debate, his approval was slightly below 40%.

Harris Ran as Biden

While many people think Harris ran as a moderate, to be more precise, Harris ran at the exact point on the ideological spectrum that Biden governed. The illusion of being a moderate was created because she shifted her policy stances from where they were in 2019 (confiscating guns, in favor of trans surgeries, opposition to fracking, in favor of Medicare for All), up to but never beyond the positions Biden held in 2024. While she renounced her previous, left-wing positions, she often didn't provide a detailed policy proposal of her own, but when enough detail was provided, she it would perfectly match Biden's policy.

Her response to every question regarding immigration policy was to support the Lankford Immigration Bill which Biden had supported, but did not have support of enough Republicans to pass. She never proposed or accepted any measure that wasn't part of that bill. On Israel/Gaza, she used the same language and answers Biden gave, that there needed to be a cease-fire and the hostages needed to be returned. There was no daylight between her and Biden on any issue.

Despite many opportunities, Harris refused to stake a position closer to the center than Joe Biden on any issue. She famously told The View and Stephen Colbert that she wouldn't do anything differently than was done by Biden. She adamantly refused to move closer to the Center than Biden governed, and that put her to the left of the median voter.

Donald Trump Ran as a Pretty Moderate Republican

Meanwhile, President Trump ran pretty close to the center. It surely doesn't seem that way because of the parts of his campaign that the media chose to highlight, but he is the least conservative president in decades on abortion, saying he does not want a national ban and he's not sure about Florida's six week ban. On immigration, probably his rightest-leaning issue, he supports deportations, but so do 51% of Americans. It flew under the radar, but Trump also indicated that he wanted to give citizenship to any immigrant who gets a degree in the US, which is surely popular.

One can also consider the outcomes of the Senate elections. Which states flipped? West Virginia, where a Democratic Senator, while a thorn in Democrats' side, eventually agreed to the Inflation Reduction Act, which sealed his fate. Montana and Ohio's Senators lost resoundingly, both red states with moderate Democrats who had won before but voted with Biden on everything. Voters are tolerant of moderates to an extent, but that tolerance was exhausted by Biden's governance.

In the end, Trump ran much closer to the center than Harris, and Harris lost because of it.

Footnotes

1 This would have ended up an electoral tie, which Trump would have won in the House.

Wednesday, October 16, 2024

Questions for Harris

Tonight, Bret Baier's interview with Kamala Harris will air. I believe it may have already been taped by now, but before it airs, here are the questions I would ask if I were interviewing her.

If I were a TV interviewer, my goal would not be "gotcha" questions, or to try to embarrass the interview subject, but to highlight important issues that voters should be thinking about. I'd certainly ask some questions that would challenge her on things she's said and done, but the goal would be informational, not to embarrass. Also, I would steer clear of questions she's already been asked, and she's answered. Even if her answers were weak, I'd assume she'd give the same.

Question 1: At what point did you decide that President Biden wouldn't be able to serve another four years as president?

The public should know if she ever reached this conclusion herself, and if she did, when she reached it. She defended President Biden when the Hur report was released, and she defended him after his debate. She can't say she knew before the debate. She will very likely avoid the question because she also doesn't want to say she believes it now, to avoid upsetting anyone. The follow-up should be why she doesn't believe this even though most of the country does, including leadership of her own party. This is an important question because it goes to her ability to tell the truth to voters, do what's best for the country, and recognize other people's abilities.

Question 2: In this week's interview with Charlamagne tha God, a listener expressed concern that Trump might "put anyone that doesn't look white in camps." You responded that the caller "hit on a really important point and expressed it well." Do you believe President Trump will put US citizens in jail based solely on their race?

This should be a pretty easy question to answer, and it gives Harris a chance to clear the record and dial down the rhetoric. If she sidesteps, she should be asked whether she is stoking fear herself and if that's the way she wants her campaign to be perceived. Every chance to dial down political rhetoric should be given to candidates.

Question 3: You've committed to putting a Republican in your cabinet, and having a bipartisan panel to advise you. Many Republicans expect that the Republican you put in your cabinet will be someone like Liz Cheney or Adam Kinzinger who many Republicans no longer consider in their party. Are these the Republicans you had in mind? If not, care to name others you would consider? Would you put a Republican who endorsed Trump in your Cabinet?

This gives Harris a chance to reach out to Republicans more specifically. Most Republicans surely don't trust her commitments to name a Republican, and this will give her the chance to build on that trust, and even look good to moderates. I doubt she'd answer the question.

Question 4: You've spoken positively about the Lankford Immigration Bill and said you'd sign it into law if you had the chance. Many Republicans believe the Lankford Bill is still too permissive. The House Republicans passed their own immigration bill in 2023 that is more restrictive. If you were president and had to negotiate with Republicans, would you support the House bill? Which provisions in it do you think are too restrictive and should be dropped?

This will be a challenging question because the Lankford bill is very Democrat-friendly, and I suspect she doesn't know much about the House bill since it hasn't been discussed much since it came out, particularly during the campaign. Voters should know her stance on immigration though. Some follow-up questions should drill down on Biden's policies, like the CBP app, the millions of immigrants who came in with refugee status, a wall. Another good follow-up would be, what would she do, through executive action to reduce the number of immigrants coming into the US illegally.

Question 5: How would your foreign policy differ from President Biden's? Would you give more money/aid to Ukraine? Is there a plan to end that war? Would you push Israel to cease its efforts? President Biden hasn't done anything/much to bring back American hostages. Would you do more?

Biden's foreign policy includes some serious gaps, and Biden hasn't had to answer questions about looking forward and how he might try to resolve issues. This question will give voters insight into Harris's thoughts on these issues and how she might face a hostile world, either the same or differently from President Biden.

Question 6: In the past, you have endorsed ending the filibuster and reforming the Court. Which of President Biden's court reforms do you support? If your party wins majorities in Congress, would you support ending the filibuster?

Institutional reforms are important to Republicans and moderates. Categorically committing to maintain institutions would benefit her reputation with both. Additionally, voters should know her stances on such fundamental government issues.

Question 7: You've proposed several initiatives to help reduce inflation. Many economists support your campaign, but economists also believe that one of the only fiscal policies that reduce inflation is reducing the budget deficit. How would your policies reduce inflation?

Simply asking about inflation will cause Harris to repeat her proposals that she's described before, but it's unlikely that those proposals would really reduce inflation. At the same time, the Federal Reserve is the primary actor in inflation. This question would allow Harris to describe her policies in more detail but also provide an explanation of how they'd work in practice.

Question 8: President Biden has been celebrated by his party and criticized by Republicans for pushing the limits of executive power and having an extremely aggressive administration, by historical standards, when it came to enacting policy without Congress. Would you continue in that mold and encourage your appointees to push the limits of executive action or would you, in line with your other bipartisan overtures, return to a more conventional administration that acts within precedent?

This will give Harris an opportunity to put some distance between her and Biden and also signal an intention towards bipartisanship and norm-adherence instead of norm-breaking.

Friday, October 11, 2024

What's the Matter with Michigan?

The majority of election-hawks seemed to have settled on election forecast models being the ideal approach to understanding elections and what polls are saying. These models undoubtedly have several characteristics that commend them--weighing polls based on several factors such as historical accuracy, introducing error to make the predictions more probabilistic (75% chance of winning for candidate X instead of predicting a winner outright), and using non-poll data to fill in some gaps from polling such as a convention bounce or undecideds.

What people should be wary of, though, is being overly confident in these models and attributing to them an objectivity or accuracy that doesn't exist. Partisanship has led to an over-confidence in these models. It's worth bearing in mind how the modelers' choices can affect the ultimate outcome and how accurate the models are, at the end of the day.

A good way to evaluate a model is by comparing to a simple average. RCP has fallen way out of favor for most election-hawks, particularly those who lean left, but it's much simpler and can be a good measuring stick even if it's not as data-driven. Also, it performed better in 2016 and 2020 than 538 did.

Why is Michigan so Different?

Right now, Nate Silver has Harris up by 1.1% (48.4 to 47.3). RCP, on the other hand, has Trump up 0.9 in Michigan (48.5 to 47.6). How can they be getting such different results? I presume most reading will reflexively think "Because RCP sucks" or the more diplomatic "Because RCP is run by conservatives who bias the results." Actually, that's not the case with Michigan.

Difference in Timing

The first difference is that RCP has a more recent cut-off. RCP considers only the 10 most recent, non-repeated polls. This effectively, for Michigan, goes back to 9/19, as of today, so 3.5 weeks. Silver's model considers polls going back to 8/30--6 weeks, double RCP. The effect of this is to add weight to older polls. If trends have moved since then, it will produce biased results. This has definitely been the case. Taking all of the polls in Silver's model, and estimating a 5 poll moving average shows movement toward Trump recently.

If Silver cut off the polls at the same time as RCP, it would move the polls about 0.2% toward Trump.

Differences in Poll Choice and Weighting

One of the smart decisions Silver made was to weight polls according to their historic accuracy along with other factors. Contrarily, RCP has a more subjective and simple weighting method. RCP's editors choose which polls to include, which usually are the most high profile ones. After that decision is made, all polls are weighted equally. On the other hand, Silver includes all polls and weights them using historic data, a measure of transparency, and sample size.

For the time period that RCP is using, it includes 10 polls, while Silver includes 16. Of the 10 that are in both 6 of them have Trump winning. Of the 16 Silver includes, Trump is winning in 7 of them. Meaning RCP is disproportionately leaving out polls which have Harris ahead. The ones in Silver's average are disproportionately less famous.

The table below shows which polls made it into the averages. It also shows Silver's letter grade for each pollster. For the most part, the cut-off for RCP corresponds to a letter grade of B-. The only exception is Mitchell Research (Trump +0.5), Morning Consult (Harris +3.5), and some combinations of polling firms.

Blue denotes polls that were included both in Silver's average and RCP's average. Taken 10/11/2024.

If all firms were included in RCP's average, weighting them all equally, however, Trump would be up by 0.9 instead of 1.0, their poll choice doesn't have much effect on the outcome.

What Else?

Beyond these explanations, admittedly, I can't figure out what's driving the difference. I don't know exactly how Silver calculates his average, but I tried accounting for house effects and weights, and can't reproduce it. I don't have the ability to plug in the non-poll fundamental effects, so it's some combination of that and his secret sauce on polling calculations that I just can't crack.

Using the weights that he provides, before accounting for house effects etc., I calculate, from his data in Michigan, that Trump is winning by -0.2%. Then adding in the house effects, I still have him winning by -0.2. (It's not that they didn't change anything; they certainly did. It's just that they cancelled each other out.

At the moment, I cannot explain how Silver's result is so pro-Harris. It's hard to believe that the fundamentals give her a 1.2% bump, but that's the only thing I can think of.

Wednesday, October 9, 2024

FTC, Break Up the Longshoreman

Background

The recent strike of the Longshoreman's union (ILA), according to news reports, centered around wages and automation. The wages issue has been tentatively resolved, but the automation issue is still alive. According to the union itself, "[We] just [want] to tighten the language that no automation means no automation." (Emphasis added)

A major complaint from the union was that there was an automated gate system at one port and possibly more. An automated gate system for trucks to pass through without needing a union representative to open and close it. This is akin to a union demanding elevator operators continue to open and close the doors for passengers like they did seventy years ago instead of it happening automatically.

Because of this union intransigence, US ports lag behind the rest of the world in terms of efficiency. The Port of New York and New Jersey has zero automation.

The FTC is charged with promoting competition in the US economy. On their logo, claim to be "protecting America's consumers." Every day, the FTC fights against anticompetitive business practices. It surely is their duty to make sure that the ports are competing with each other to provide the best services to consumers--both the ultimate American producers and consumers who benefit from the goods that are conveyed through the ports and the immediate ones like shipping companies.

Why This Case Demands Additional Attention

In a normally functioning, competitive port economy, ports would be competing with each other to provide the most efficient service to shipping companies and producers, which would include making improvements in automation at its facilities so it could move the maximum amount of goods, as fast as possible, all day every day. This competition would benefit American consumers because it would reduce the costs of shipping and allow for even more and better goods to be available.

If one port fell behind, then shippers would use other ports and encourage laggards to keep up. This is exactly how competition works in every other industry, and as long as the costs of switching, i.e. shipping items through North Carolina instead of South Carolina, or Jacksonville instead of Miami, are low, then competition can be really effective. In fact, we can be pretty confident this would happen because it is happening throughout the world. The US ports, particularly on the East coast, are falling behind because the rest of the world operates much more competitively.

US ports are falling behind because the rest of the world operates much more competitively.

The reason the East coast is falling behind is that competition is not allowed to take place because there is a monopoly. Not a conventional monopoly of firms or the ports, but of labor. Even though the ports are independent and compete with each other, one union's workers control more than 90% of East coast shipping.1 The unions are allowed to have a monopoly of employees which is being used to produce anti-competitive and anti-consumer outcomes.

One union controls more than 90% of East coast shipping.

Imagine if Amazon Web Services, which provides cloud data for companies, controlled 90% of the cloud market, meaning it hosted company websites and data, and it was the only one that did (instead of competing with Microsoft and Google among others). What if Amazon told its customers that they won't provide compression for data for any customer, so every customer has to store its data at full size and take up more space and pay Amazon more. Further, if any customer tries to go elsewhere or host their own site, Amazon will stop hosting their data altogether, badger them, conduct a national marketing campaign calling them "scab" companies and urging everyone to boycott them. Do you think the government would get involved?

Imagine if there was one cloud data provider and it told its customers that it refused to store compressed data, forcing customers to pay more, and there was nowhere else they could go.

Every union holds some level of monopoly. Some unions control labor at a single firm, and some unions hold large manufacturers such as car companies. However, the Longshoreman's union controls practically every port on the Eastern seaboard that provides international container shipping. Domestic automobile companies still compete with non-unionized foreign automobile companies, or plants in right-to-work states with no unions. This competition keeps pressure on the car companies to keep up with technology even if it hurts union members' job prospects. There is no such competitive pressure for the ports.

Because the anti-consumer, anti-competitive group is a union, the FTC doesn't do anything, but given their new approach, where they expand their areas of concern beyond just prices to effects on labor, perhaps they should also expand the focus beyond corporations to labor so they can break up this union that is holding American shipping back.

1Author's calculations based on data from Bureau of Transportation Statistics.

Wednesday, September 25, 2024

The ACA Achieved None of Its Goals

It's been more than ten years since the ACA was fully implemented, and by most measures it has failed. In the 2008 election and the later part of 2009, healthcare reform was a top issue. For much of the campaign, before the financial crisis hit in mid to late 2008, it was the top issue. Candidates Obama and Clinton sparred frequently on the topic. The documentary film Sicko, Michael Moore's follow-up to his enormously popular Bowling for Columbine, and not quite as popular Fahrenheit 9/11 investigated the health care industry from many angles and served as a foundation for much of the criticism of the industry and urgency for reform.

The goals of healthcare reform were numerous. The overarching goal was to reduce the number of uninsured in the U.S. Almost as important was to reduce costs and improve outcomes. Few people have looked back at the full slate of goals of the ACA or the projections that accompanied it. Mostly, policy wonks focus on the one goal for which it was relatively effective and ignore the rest. Looking at all of the dimensions, though, and how they progressed over the past fifteen years shows that the ACA didn't solve almost any of the problems that were the biggest discussion points before the legislation even existed, and it often didn't meet the expectations set for it after it was written.

Uninsured

The primary goal of the ACA was to reduce the number of Americans who didn't have insurance. In the run-up to the legislative effort, the number of uninsured was ubiquitous in the news. While that goal was based on numbers that were greatly misrepresented (70% of the new Medicaid enrollees were eligible prior to ACA and chose not to sign up, and another large subset were illegal immigrants), even the expected reduction was never achieved.

CBO estimated that, by 2019, the number of uninsured would fall by 31 million. In reality, it fell by less than 15 million, before accounting for population growth and the booming 2019 economy. The Urban institute estimated a reduction of around 28 million.

Behind the numbers, Medicaid was expected to grow by 16 million, but it actually added 20 million more beneficiaries. The exchanges were projected to insure an additional 23 million Americans. By 2019, only 11 million people enrolled in an exchange plan.

The largest miss, and the biggest failure of the ACA is that it completely decimated the existing non-group insurance option. Before the ACA, there were approximately 15-17 million enrolled in private plans. By 2019, the combined enrollment in ACA and non-ACA plans was just under 19 million, meaning that the exchanges and subsidies did not generate much net improvement in the insurance rate because most of the ACA gains came out of or at the expense of the existing private plans.

Premiums

It's a universally acknowledged miss that President Obama promised that the ACA would "bend the cost curve down." He specifically said that the ACA would lower premiums for families by $2500/year on multiple occasions.

In 2017, Forbes published an article already calling into question this result.

Using National Health Expenditure Data provided by CMS, one can verify that the Forbes article was correct. Increases in private per enrollee costs grew faster after the implementation of the ACA. Costs for "Other Direct Purchase" which includes off-exchange plans, rose 5.4% per year from 2001 to 2013, and 8.6% per year from 2013 to 2022, after the ACA was implemented. Marketplace plans, specifically, have increased, on average 5.3% per year.

While the ACA was supposed to make insurance more affordable, the costs of insurance rose faster after its implementation compared to before. Everyone doesn't incur those costs equally, however. People who are insured through Marketplace plans may be eligible for some level of subsidy, depending on their income, which reduces the costs to them of the increased premiums. Those millions who are not eligible are now much worse off than they were before the ACA.

Costs for Exchange Plans are higher than the private, non-exchange plans

Note also that studies were done in 2013 projecting, due to experience up to then, that premiums would save even more money. Few studies have been done since, but every indication is that this was just a temporary phenomenon.

Outcomes

The most widely discussed health outcome prior to the ACA was US life expectancy. The fact that Cuba had a higher life expectancy than the US was frequently used to claim that the Cuban health care system was superior to the US's. Remarkably, since the passage and implementation of the ACA, life expectancy has improved at a much slower rate than before passage.

src: Data Commons

In addition to life expectancy, a primary goal of healthcare reform was to reorient care towards prevention and reduce emergency visits. According to CDC, the ED visit rate was unchanged between 2009 and 2019.

Conclusion

A careful review of the main healthcare challenges that were being discussed in the run-up to 2010, the problems politicians and media said would be solved shows that for every one of them, the ACA failed to solve the problem. In one case--the insurance rate--it helped, but in every other dimension--affordability, outcomes, appropriate coverage--it failed. Maintaining a rich skepticism of government's proposed solutions and their expectations cannot be emphasized enough.

Assorted Links

Side Comment on Using AI Resources

I'm not optimistic about ChatGPT or its competitors. There's clearly an existing internet bias towards the left, because the left produces more content. Try a google news search on a topic where you know there's a good right-leaning argument. You probably won't find it.

— Chris Oldman (@ChrisOldman4) September 27, 2024

As a side note, multiple AI chatbots said that the ACA did better at providing insurance, but wouldn't give me any source.

In addition, multiple said premiums have risen more slowly after ACA. One pointed me to this study done in 2013, before full implementation, and based on a weird metric, this study that reports individual year results, not the trend after ACA or before.