Michael Tanner of the Cato Institute offers National Review Online readers his assessment of the Affordable Care Act’s track record.

Tanner questions the proposition that Obamacare is “working,” a claim based on a recently reported decline in the percentage of Americans who are uninsured. He reminds us that much of that decrease can be attributed to an improving economy, which has led more people to health insurance coverage because they have new jobs.

Still, the ACA can rightly be credited with some of the gains. If you subsidize something, you should expect to get more of it. And Obamacare heavily subsidizes health insurance.

The problem is, that statement uses the term “insurance” very loosely. In actuality, roughly 60 percent of those newly “insured” through Obamacare are actually being enrolled in Medicaid. And Medicaid is hardly the same as real insurance.

While Medicaid costs taxpayers a lot of money, it pays doctors little. As a result, many doctors limit the number of Medicaid patients they serve, or refuse to take them at all.

An analysis published in Health Affairs found that only 69 percent of physicians accept Medicaid patients. Another study, in the New England Journal of Medicine, found that Medicaid recipients were six times more likely to be denied an appointment than people with private insurance. And, according to a third study, when they do get an appointment, they wait an average of 42 days to see a doctor, twice as long as the privately insured.

Just last month HHS’s Office of Inspector General released a report showing how difficult it was for Medicaid patients to gain access to care through Medicaid managed-care programs. IG inspectors posed as Medicaid patients and called designated Medicaid managed-care providers. More than half of listed providers could not be found at the location listed. Others were found but were not participating in the plan, while still others were no longer taking new Medicaid patients. When the investigators were able to get appointments, they faced lengthy average wait times. In 28 percent of cases, they had to wait longer than a month to see a doctor. Ten percent of the time, the wait exceeded two months. A 2012 report from the Government Accountability Office (GAO) confirmed that Medicaid patients faced serious accessibility problems.

And things are about to get even worse.