The Washington Post editorial board used the latest Census data showing that the rate of U.S. residents without health insurance continues to drop as proof that the Affordable Care Act (ACA) -- commonly referred to as Obamacare -- is working. The paper also argued that Obamacare would help millions more Americans if Republican-led states accepted federal subsidies to expand Medicaid. Right-wing media outlets have spent years encouraging the ongoing obstruction of this key provision of health care reform.

In a September 17 editorial, the Post highlighted the U.S. Census Bureau’s annual report on health insurance coverage, which showed that the percentage of people with health insurance had risen to 90.9 percent nationwide in 2015. The editorial board noted that the same report showed room for even more improvement in expanded health insurance coverage if the law were fully implemented at the state level. According to the Census data, the uninsured rate in states that did not accept Medicaid expansion under the ACA is still 12.3 percent, far above the national average and even further still from the 7.2 percent uninsured rate in states that have accepted the law’s allocation of funds for low-income Americans. In the Post’s view, the 19 states that continue to refuse Medicaid expansion are “irrationally holding out,” not only because their refusal of “huge amounts of federal money” has denied 4 to 5 million more Americans access to health care, but also because studies have shown that each state would receive vastly more money from the government than it would spend on expansion. From The Washington Post:

But the overall number could be cut much lower, and quickly, if Obamacare were working as it was meant to. We are not referring to the recent, much-discussed exit of some major health insurers from the marketplaces the law created. We are talking about Obamacare’s expansion of Medicaid, the state-federal health plan for the poor and near-poor. The Supreme Court in 2012 made the expansion optional for states, and a large chunk, including Virginia, have refused. The Census Bureau found that the uninsured rate was 7.2 percent in expansion states last year and 12.3 percent in non-expansion states. Five states have expanded since, but that still leaves 19, representing 4 million to 5 million people who would otherwise get coverage, irrationally holding out.

Why irrationally? In their effort to hobble Obamacare, state Republican leaders have left huge amounts of federal money on the table. The federal government has offered to pay nearly the whole cost of the expansion, forever. Though states must pitch in a bit, they get a much lower uninsured rate, lower uncompensated care costs and other savings in return. The Urban Institute found last month that the 19 holdout states would get an average of $7.48 from the federal government for every dollar they spent on Medicaid expansion. Even those costs, meanwhile, would likely be further offset by savings elsewhere. States that have already expanded, in fact, have generally seen net revenue gains.

The Post dinged “state Republican leaders” for “their effort to hobble Obamacare,” but continued obstruction to the law remains a feature of right-wing media coverage as well. For years, Fox News fueled obstructionist politicians by promoting myths that expanding Medicaid was costly for states; in reality, states that expanded Medicaid saw slower health care cost increases than non-expansion states, and August 2016 research from the Urban Institute shows that the remaining holdouts stand to benefit enormously from Medicaid expansion. After discouraging states from taking part in the law, Fox absolved itself (and Republicans) of responsibility for the resulting coverage gap, which it framed as as “another problem growing out of Obamacare.”

Right-wing media have smeared Obamacare for years with baseless catastrophic predictions and falsehoods, and while their fearmongering has been stunningly wrong, it has continued unabated. Positive news about Obamacare -- like its role in reducing medical debt and increasing public health, or the record low uninsured rates driven by the law -- goes unmentioned by conservative outlets while they hype isolated program stumbles as the onset of a looming “death spiral” that will destroy the health care system.