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In our states — Washington, Kentucky and Connecticut — the Affordable Care Act, or “Obamacare,” is working. Tens of thousands of our residents have enrolled in affordable health-care coverage. Many of them could not get insurance before the law was enacted.

People keep asking us why our states have been successful. Here’s a hint: It’s not about our Web sites.

Sure, having functioning Web sites for our health-care exchanges makes the job of meeting the enormous demand for affordable coverage much easier, but each of our state Web sites has had its share of technical glitches. As we have demonstrated on a near-daily basis, Web sites can continually be improved to meet consumers’ needs.

The Affordable Care Act has been successful in our states because our political and community leaders grasped the importance of expanding health-care coverage and have avoided the temptation to use health-care reform as a political football.

In Washington, the legislature authorized Medicaid expansion with overwhelmingly bipartisan votes in the House and Senate this summer because legislators understood that it could help create more than 10,000 jobs, save more than $300 million for the state in the first 18 months, and, most important, provide several hundred thousand uninsured Washingtonians with health coverage.

In Kentucky, two independent studies showed that the Bluegrass State couldn’t afford not to expand Medicaid. Expansion offered huge savings in the state budget and is expected to create 17,000 jobs.

In Connecticut, more than 50 percent of enrollment in the state exchange, Access Health CT, is for private health insurance. The Connecticut exchange has a customer satisfaction level of 96.5 percent, according to a survey of users in October, with more than 82 percent of enrollees either “extremely likely” or “very likely” to recommend the exchange to a colleague or friend.

In our states, elected leaders have decided to put people, not politics, first.

President Obama announced an administrative change last week that would allow insurance companies to continue offering existing plans to those who want to keep them. It is up to state insurance commissioners to determine how and whether this option works for their states, and individual states will come to different conclusions.

What we all agree with completely, though, is the president’s insistence that our country cannot go back to the dark days before health-care reform, when people were regularly dropped from coverage, and those with “bare bones” plans ended up in medical bankruptcy when serious illness struck, many times because their insurance didn’t cover much of anything.

Thanks to health-care reform and the robust exchanges in our states, people are getting better coverage at a better price.

One such person is Brad Camp, a small-business owner in Kingston, Wash., who received a cancellation notice in September from his insurance carrier. He went to the state exchange, the Washington Healthplanfinder, and for close to the same premium his family was paying before got upfront coverage for doctor’s office visits and prescription drug , vision and dental coverage. His family was able to keep the same insurance carrier and doctors and qualified for tax credits to help cover the cost.

Since Howard Stovall opened his sign and graphics business in Lexington, Ky., in 1998, he has paid half the cost of health insurance for his eight employees. With the help of Stovall’s longtime insurance agent and Kentucky’s health exchange, Kynect, Stovall’s employees are saving 5 percent to 40 percent each on new health insurance plans with better benefits. Stovall can afford to provide additional employee benefits, including full disability coverage and part of the cost of vision and dental plans, while still saving the business 50 percent compared with the old plans.

In Connecticut, Anne Masterson was able to reduce her monthly premiums from $965 to $313 for similar coverage, including a $145 tax credit. Masterson is able to use her annual premium savings of $8,000 to pay bills or save for retirement.

These sorts of stories could be happening in every state if politicians would quit rooting for failure and directly undermining implementation of the Affordable Care Act — and, instead, put their constituents first. Health reform is working for the people of Washington, Kentucky and Connecticut because elected leaders on both sides of the aisle came together to do what is right for their residents.

We urge Congress to get out of the way and to support efforts to make health-care reform work for everyone. We urge our fellow governors, most especially those in states that refused to expand Medicaid, to make health-care reform work for their people too. http://www.washingtonpost.com/opinions/how-we-got-obamacare-to-work/20
13/11/17/3f2532bc-4e42-11e3-be6b-d3d28122e6d4_story.html?hpid=z3

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Without some type of insurance expansion for the state’s poorest, hospital emergency rooms will continue to be overwhelmed by uninsured patients who don’t go to the doctor unless it’s at the ER, he said. This drives up health care costs and insurance premiums for everyone else, Lunsford noted.

Paula Gomez, executive director of the Brownsville Community Health Center, said her clinic treats a little more than 20,000 patients a year. Between that and Su Clinica’s Brownsville clinic, she estimates only 15 percent of the actual need is being met in the city.

“People are waiting till their illness gets to the point where they end up in the emergency room, and at that point we pay for it anyway because they still don’t have ability to pay,” she said. "Analysts: Texas loses big by rejecting Medicaid expansion", http://www.brownsvilleherald.com/news/local/article_caf425ee-d0ae-11e2
-b684-001a4bcf6878.html]

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Florida Governor Rick Scott joined an esteemed group yesterday—-he became the seventh GOP governor to flip-flop and announce his support for the expansion of Medicaid in his state. Chances are more Republican governors will follow suit.

So what led to his change? One word: hospitals. Not only have hospitals, on average, supported expansion of Medicaid from its announcement, but they’ve also been working overtime recently to convince Republican governors and state legislators that it’s the financially smart thing to do. “If Florida doesn’t expand Medicaid, we’re going to have the money taken out of one pocket (by the federal government), we just won’t get it put back in the other,” Tommy Inzina, chief administrative officer at BayCare Health System, told the Florida House this week ( http://www.miamiherald.com/2013/02/19/3242496/fla-hospitals-push-for-m
edicaid.html).

In 2011 Florida hospitals spent $2.8 billion caring for the uninsured and had to write off the majority of that bill. That’s up from $2.4 billion in 2006–when 1.7 million uninsured were treated–and the trend will only get worse ( http://www.insidearm.com/daily/medical-healthcare-receivables/medical-
receivables/florida-hospitals-uncompensated-care-costs-skyrocket/) unless more state residents are insured. The expansion could have a monumental impact by insuring one million newly eligible people in the first year alone.

Similarly, in South Carolina, Republican Gov. Nikki Haley’s opposition to expansion is softening as hospitals support expansion with their voices and now their wallets; they say they’ll consider a provider tax to help pay for any state costs of the expansion. Bob Coble, a lobbyist for hospitals and providers, told The State, “It would, essentially, be the health-care industry taxing itself to pay (it).” ( http://www.mlive.com/politics/index.ssf/2013/02/rick_snyder_medicaid_o
bamacare.html)

So while the GOP’s statements on the expansion may not add up, the math does. “Expansion will create more access to primary care providers, reduce the burden on hospitals and small businesses, and save precious tax dollars,” said Rick Snyder (( http://www.thestate.com/2013/01/30/2610520/hospitals-could-pay-to-expa
nd.html), Michigan’s Republican governor, when he caved earlier this month.

The federal government will foot 100% of the bill for Medicaid expansion until 2017. But even up until 2023, the Congressional Budget Office estimates states will pay only 10% of the costs. What happens after 2023? There’s little doubt Florida and other states will have to chip in more money as their populations continue to rise and more people are eligible for Medicaid. But hospitals are open to future cuts and understand the budget situation is always in flux. What they’re not open to is having the next nine years look like the previous nine. http://www.forbes.com/sites/janetnovack/2013/02/21/why-gop-governors-a
re-caving-on-medicaid-expansion/#

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