TY - JOUR T1 - Is Obamacare working? JF - British Journal of General Practice JO - Br J Gen Pract SP - 360 LP - 361 DO - 10.3399/bjgp14X680653 VL - 64 IS - 624 AU - John J Frey III Y1 - 2014/07/01 UR - http://bjgp.org/content/64/624/360.abstract N2 - The answer, as one might imagine, depends completely on whom you ask. The recent, end of March deadline had most members of the Obama administration very happy, showing over 8 million people signed for insurance through state and federal exchanges, which exceeded their goals.1 Overall, 31 states exceeded their targets for enrolment, including a number of heavily Republican states in the South.2 So the answer from the administration would be ‘yes’.The Republicans would say, of course, ‘no’, because that is what they say about anything that might extend financial support for people on a low-income, especially anything proposed by President Obama. The Republican House has voted 54 times now to repeal or alter the Affordable Care Act (ACA). It gives them something to do while they are not passing any legislation of importance on, let’s say, climate change or immigration.States could either design the exchange process themselves or punt it to the federal exchange, which has had well-publicised start-up problems and website crashes. The states that chose to do it themselves were often surprising. Kentucky is a poor state whose economy relies on tobacco and coal (not the best products on which to build a future). Yet Kentucky, led by a practically minded Democratic governor and despite having two of the more reactionary senators in Congress, used federal dollars to help dramatically increase the number of people on Medicaid and begin to enrol people in private programmes.Georgia and Florida were two other states with large enrolments through the federal exchange. Both states are seeing a large demographic shift with increases in African-American and Latino populations that are changing the voting profile to potentially be more Democratic. The governor of Florida, a former champion of industry in the country’s largest for-profit healthcare system, which paid $2 … ER -