Twenty million more people today have health insurance than before the Affordable Care Act launched in 2010. That's a million more than the combined populations of Missouri and Illinois.

Yes, the Obama administration announced Monday that premiums on most government health exchanges will increase next year by an average of 25 percent. That's bad news, and there's no way to sugarcoat it.

Private insurers underpriced their plans, and this is a course correction. The signature achievement of President Barack Obama's administration will need some fixes. But 20 million people refute Republican presidential candidate Donald Trump's assertions that "Obamacare is a disaster."

There is no such disaster. Polls show most Americans are happy with, or are at least unaffected by, Obamacare. The loud opposition to it has been politically driven. Five percent of taxpayers — those earning $250,000 or more — are paying a little more in Medicaid taxes to pay for health care for other people. Republicans in Congress care deeply for these wealthier people and would ration health care by income if given the chance.

Fundamentally, a small percentage of Americans have not accepted the proposition that health care is a basic human right. The Nov. 8 election is, in part, a referendum on that proposition. The challenge now is how to make the Affordable Care Act work better.

The fact is that even with next year's premium increases for the benchmark mid-level policy, Obamacare is still coming in at the costs projected by the Congressional Budget Office in 2009. The costs of plans on the government health care exchanges are in line with those of employer-sponsored plans.

Costs differ greatly by state, depending on how many private insurers are competing for business. On average, the Department of Health and Human Services announced Monday, monthly premiums for the midlevel "silver" coverage will go up in Missouri from $257 to $305. In Illinois, the cost will go up from $208 to $298.

Democratic presidential candidate Hillary Clinton has supported a public option, whereby the government would compete with private insurers, thus driving costs down. If that's unpalatable, the government could impose a stronger insurance mandate.

Right now too many younger, healthier Americans who don't qualify for subsidies are opting not to buy insurance at all. If disaster strikes, they can pay a penalty that's cheaper than insurance.

Thus Obamacare enrollees tend to be older and sicker, and thus more costly to insurers. The three-month enrollment period that begins Nov. 1 will be critical to expanding the risk pool.

Asking the Affordable Care Act of 2010 to be the last word in health care is like expecting the Wright brothers plane of 1903 to be the last word in aviation. Americans make things better. Health coverage should be no exception.

REPRINTED FROM THE ST LOUIS POST DISPATCH