In 2015, something unexpected and unusual happened to the United States. For the first time since 1993, life expectancy in the United States declined. The decline was significant and extensive. Life expectancy is one of the most basic indicators of human health and the United States is one of the most advanced nations in the world. The decline should be causing a careful consideration of its causes and potential solutions. This is largely being ignored by our intellectual leadership for a rather obvious reason: the Affordable Care Act that promised to make health insurance more affordable and available for Americans. Recognizing the most important achievement of the Obama administration and its potential role in declining health outcomes for Americans is an important investigation.

The problems with the law did not prevent late night comedian Jimmy Kimmel from making the fallacious appeal that his young baby would die without ObamaCare. Anyone who tries to discuss the ACA knows that the most innocent and vulnerable person we can imagine (except for an unborn child) will die if we criticize and otherwise alter the Affordable Care Act. We need to employ reasonable critical thinking skills that are under such constant attack on college campuses, to reverse the decline in life expectancy in the United States. 

The Affordable Care Act came into legislative existence in 2010 and has increased its influence over health care delivery in the United States every year since. At the heart are mandates that every American purchase health insurance. Defenders of the ACA proudly boast that at least an additional 10 million Americans have gained health insurance with the addition of the law. Some have gone as far as extrapolating how this has saved life. If this is true, why has life expectancy declined so dramatically? The problem is significant.

The Washington Post provides a sense of the danger in December 2016:

“For the first time in more than two decades, life expectancy for Americans declined last year -- a troubling development linked to a panoply of worsening health problems in the United States.

Rising fatalities from heart disease and stroke, diabetes, drug overdoses, accidents and other conditions caused the lower life expectancy revealed in a report released Thursday by the National Center for Health Statistics. In all, death rates rose for eight of the top 10 leading causes of death. “I think we should be very concerned,” said Princeton economist Anne Case, who called for thorough research on the increase in deaths from heart disease, the No. 1 killer in the United States. “This is singular. This doesn’t happen.””

The abrupt conclusion of the Post article is a clue of how we are not allowed to refute or criticize the ACA or other progressive political acts: “Meara noted that more people need better health care but that “the health-care system is only a part of health.” Income inequality, nutrition differences, and lingering unemployment all need to be addressed, she said.” The last sentence is the only clue that the Washington Post thought maybe the American health care system would have something to do with dramatic increases in death rates for American due to a variety of diseases ranging from heart disease to diabetes and pneumonia. Eight of the ten leading causes of death for Americans showed increases in mortality for Americans. This is rather important to demonstrate how health care has collapsed. In 1993, when life expectancy last declined, HIV was ravaging Americans with such consequence that its singular effects were profound and yet still largely difficult to combat through medicine. All the things killing Americans in 2015 are treatable and can be reduced. Overall, the New York Times concedes that more than 85,000 deaths resulted from this decline in American health in 2015 alone. This translates to more than 230 Americans a day who may be dying as a result of the Affordable Care Act. Again, the New York Times was completely unwilling to scrutinize the ObamaCare as a potential cause even though it the most significant national change to the health care in our country since Medicare and Medicaid.

How might ObamaCare harm American health care?

The ACA has raised deductibles and premiums for Americans. Both of these factors can work to reduce incentives to seek medical care. These effects would well explain the lack of popularity for ObamaCare. Americans who were not able to keep a doctor they were familiar with or the health care plan they already understood could be refusing to seek the medical care they need. All of this is speculation because not only do the New York Times, ABC News, and the Washington Post refuse to investigate the adverse effects of the ACA, they actively work to refute criticism of the law.

ObamaCare also has profound effects of regulation that are likely damaging our medical innovations. Taxes on medical devices dampen innovation. Regulations on what insurance companies must cover complicate the process whereby doctors treat patients. This interference in the doctor/patient relationship demoralizes both doctors and patients and diminishes American health care. Doctors are more likely to quit the calling of medicine and patients are demoralized by the lack of options alongside byzantine insurance demands. The mandate regarding pre-existing conditions discourages the purchase of health care insurance as well. Knowing that insurers cannot discriminate against individuals with prior medical conditions means that, especially for young people and apparently healthy people, buying health insurance is an unwise diversion of monthly income that is greater than the tax penalties for refusing to buy insurance. Little is said about this disincentive to health insurance purchases.

The ACA also dampened economic growth in the United States by encouraging employees to be demoted to less than full-time status and punishing businesses that have more than 49 employees. The sluggish economic growth from 2010 to 2016 factored into the demoralized flyover nation that does not receive the same quality of medical care as the politically preferred coasts. Suicides, accidental deaths, and drug abuse are all important drivers to accelerating death rates. Americans continued to spend more than $9,000 a year on health care -- more than any other nation by far, and yet this spending has failed them. A breakdown of life expectancy by state shows that the states voting for Clinton have better health care results -- something some commentators note with cynical delight. The idea of killing Trump voters has a cynical ring to the Jacobin ranks of the American left. The Washington Post was again early to this subtle call for passive violence against Trump voters. The problem seemed to be that Trump voters were not dying fast enough.

What can be done?

The most important thing that can be done is for our intellectual culture to stop worshipping the politically sacred cow that is the Affordable Care Act. Careful reconsideration of ObamaCare could save hundreds of lives everyday in the United States. The Washington Post is right -- or maybe we should say Left -- “Democracy dies in darkness.” Bringing light to the ACA’s role in reducing American life expectancy could go a long way toward not only revitalizing our democracy with a free press, but also saving American lives. We need a discursively complex society that can reconsider its most cherished ideological assumptions. We need to think critically about the defects of our ACA driven health care system. 

Ben Voth is an associate professor of Corporate Communication and Public Affairs and Director of Debate at Southern Methodist University in Dallas.