A health care worker in Minnesota wears a button supporting the Affordable Care Act in 2013.

A health care worker in Minnesota wears a button supporting the Affordable Care Act in 2013. Jessica Hill/AP file photo

Report: Americans' Health Is Improving Under Obamacare

A Journal of the American Medical Association study says trends in self-reported health are rebounding under the health care law.

Americans say they're feeling healthier under Obamacare.

That was the conclusion of a major new study, in which researchers poured over the survey responses of more than 500,000 American adults spanning several years, released Tuesday in the Journal of the American Medical Association.

It isn't clear exactly how much credit the law can take. But if past experience holds true, the Affordable Care Act is at least contributing to people feeling a little bit better these days.

Compared with the pre-ACA trend, fewer Americans say they are in fair or poor health, and they are reporting fewer days in which their activity was limited by poor health. The JAMA study was conducted by researchers on behalf of the U.S. Health and Human Services Department, which reviewed the findings of the Gallup-Healthways Well-Being Index survey from 2012 to 2015.

The raw percentage of people saying they were in fair or poor health declined from the law's first open-enrollment period to the second. The study also compared that new ACA reality with the trend lines prior to the health care law; it found that the percentage of people reporting fair or poor health was 3.4 percentage points lower at the end of March 2015 than researchers would have expected if the law never took effect.

The percentage of people saying they had days in which their activity was limited by bad health was 1.7 percentage points lower than the pre-ACA trend line would have anticipated.

"The trend that was in effect before open enrollment, where things were getting worse, either flattened out or, for poor health, actually was getting better," Benjamin Sommers, a Harvard University assistant professor who led the research, told reporters in a conference call reviewing the findings.

Can Obamacare actually take credit for that? Sommers said it was hard to be precise, but past experience suggests that it is at least partly responsible.

The study referenced research into Massachusetts health reform and the well-known Oregon Health Experiment, which tracked the outcomes for people who enrolled in Medicaid through a lottery, which found coverage expansions were accompanied by better self-reported health. In those cases, Sommers said that change could be seen fairly quickly.

"Some of it could be simply peace of mind, that the stress of worrying about how you're going to pay for medical care if you have a medical problem itself could be a cause of depression, a cause of stress-related medical complications," he said. "Another is that people who have urgent issues to take care of may actually be getting care quickly and improving some of the symptoms that are affecting their quality of life."

The researchers cannot, however, rule out that there are other factors that they haven't yet detected. "The overall pattern, though, is consistent with what previous studies of insurance expansions have shown, with pretty rapid improvements in self-reported health," Sommers said.

The study's other findings generally align with the body of post-Obamacare implementation research: Declines in the uninsured rate, the percentage of people who lacked access to a primary-care doctor, and the percentage of people unable to afford health care.

The paper also noted a bigger change in each metrics in the states that have expanded Medicaid through the law; 20 states still have not accepted the expansion, ruled optional by the Supreme Court in 2012.