The ACP Advocate Blog
by Bob Doherty
Monday, October 18, 2010
Record Number of Uninsured, While Millions More Look to the Government for Help
Last month, the U.S. Census Bureau released its annual survey on health insurance coverage. The results were startling, yet few politicians seemed to take notice.
- The number of people with health insurance declined for the first time ever in almost two decades. In fact, as reported by CNN this is the first time since the Census Bureau started collecting data on health insurance coverage in 1987 that fewer people reported that they had health insurance: "There were 253.6 million people with health insurance in 2009, the latest data available, down from 255.1 million a year earlier." The percentage of the population without coverage increased from 15.4 percent to 16.7 percent.
- Almost 51 million U.S. residents had no health insurance coverage at all, a record high, and an increase of almost five million uninsured from 2008.
- Fewer Americans received health insurance coverage through their jobs, continuing a decade-long trend. The number covered by employment-based health insurance declined from 176.3 million to 169.7 million, reports the Census Bureau. Based on the Census numbers, the Economic Policy Institute observes that "the share of non-elderly Americans with employer-sponsored health insurance declined for the ninth year in a row, down from 61.9% in 2008 to 58.9% in 2009, a total decline of 9.4 percentage points since 2000."
- More people than ever relied on government programs for coverage and fewer on the private sector. The number with Medicaid coverage increased from 42.6 million to 47.8 million. According to the Census Bureau: "Comparable health insurance data were first collected in 1987. The percentage of people covered by private insurance (63.9 percent) is the lowest since that year, as is the percentage of people covered by employment-based insurance (55.8 percent). In contrast, the percentage of people covered by government health insurance programs (30.6 percent) is the highest since 1987, as is the percentage covered by Medicaid (15.7 percent)."
These are the facts on the ground, folks, no matter how much the politicians choose to ignore them. Without Medicaid and Medicare, many tens of millions more Americans would be without health insurance. Financially-strapped states already are picking up much of the tab of enrolling millions more in Medicaid. And the Great Recession has shown us that most of us are just a lay-off away from losing our health insurance.
The Affordable Care recognizes the unreliability of our current health insurance system and fills the gaps. If it is allowed to be implemented, the ACA would give people who don't have job-based coverage access to subsidized and affordable private health insurance. The federal government would pay the states more for enrolling low-income people in Medicaid (100% of the cost initially, dropping to 90% by 2020); this would be money the states would be able to count on, instead of being buffeted by higher Medicaid costs whenever there is an economic downturn.
The Great Recession should also have taught us that lack of health insurance isn’t someone else's problem, but everyone's concern. The fact that "nearly every demographic and geographic group posted a rise in the uninsured rate" last year shows how vulnerable we all are to losing our health insurance coverage. The Affordable Care Act isn't perfect, but at least it would provide coverage to 95% of all U.S. residents, a far cry from the record number of uninsured in 2009.
Today's question: What is your reaction to the Census Bureau findings and what does this mean for health reform?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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