By Zac Auter
Gallup, January 16, 2018
The percentage of U.S. adults without health insurance was essentially unchanged in the fourth quarter of 2017, at 12.2%, but it is up 1.3 percentage points from the record low of 10.9% found in the last quarter of 2016. The 1.3-point increase in the uninsured rate during 2017 is the largest single-year increase Gallup and Sharecare have measured since beginning to track the rate in 2008, including the period before the Affordable Care Act (ACA) went into effect. That 1.3 point increase represents an estimated 3.2 million Americans who entered the ranks of the uninsured in 2017.
Several factors likely contributed to the increase in the uninsured rate in 2017. Some insurance companies stopped offering insurance through the exchanges, and the resulting lack of competition drove up the cost of plans for consumers. This may have caused some Americans, especially those who failed to qualify for federal subsidies, to forgo insurance.
Further, media coverage of the policies to repeal and replace the healthcare law may have caused some consumers to question whether the government would enforce the penalty for not having insurance. Congressional Republicans made several attempts to repeal or replace the healthcare law during 2017, ultimately passing a tax bill in December that repealed the individual mandate.
The uninsured rate rose for all demographic groups in 2017, with the exception of those aged 65 and older, all of whom qualify for Medicare coverage. It increased most among young adults, blacks, Hispanics and low-income Americans.
By far, the biggest change in 2017 was the decline in the percentage of Americans purchasing their own plans, likely through ACA healthcare exchanges.
Having passed their tax bill, congressional Republicans’ 2018 legislative goals include reforming funding mechanisms for Medicaid and Medicare — programs that subsidize healthcare coverage for low-income, disabled and elderly Americans. With less federal assistance from these programs to help offset the rising cost of health insurance, fewer Americans may be able to afford health insurance.
By Don McCanne, M.D.
According to this Gallup/Sharecare survey, in the past year the number of uninsured Americans increased from 10.9% to 12.2%, an increase of 3.2 million individuals.
Although supporters of the Affordable Care Act can cite reasons for this reversal of the prior increase in the numbers who are insured, doesn’t that merely confirm that our current system is not working if we agree that truly universal coverage – absolutely everyone – is an essential goal of reform? Yet supposedly progressive reform advocates are coming out of the woodwork to dismiss the single payer concept as they propose mere additions to our highly dysfunctional financing system, leaving all of the flaws in place.
What we can say is that the current system is falling miserably short. Too many remain uninsured; many more remain underinsured; administrative excesses continue to ramp up; lack of affordability and financial hardship have been perpetuated; choice in health care professionals and institutions is diminishing, and burnout is rampant. A well designed single payer system would fix these problems. This decline in the numbers who are insured proves that the current system, even with tweaks, is not up to it.
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