Health Insurance Coverage Still Low Despite ACA Policies

By Sara Heath
RevCycle Intelligence, Sept. 17, 2015

Health insurance coverage woes continue to affect a great number of individuals, claims the president of Physicians for a National Health Program (PNHP).

According to a recent press release, Robert Zarr, MD, argues that despite the increase in health insurance coverage since the implementation of the Affordable Care Act (ACA), there are still notable and “unacceptable” disparities in coverage amongst underserved individuals.

According to Zarr, the Census Bureau reported that the number of uninsured individuals dropped from 42 million in 2013 to 33 million in 2014. This considerable drop is perhaps a result of the ACA. As reported by RevCycleIntelligence.com, between 2014 and 2015 the uninsurance rate decreased by 8 percent.

Additionally, the number of individuals forgoing a primary care visit decreased by 3.5 percent, and the number of individuals without easy access to medication decreased by 2.4 percent. Overall, the number of individuals reporting fair or poor health decreased by 3.4 percent.

While Zarr notes that these decreases in uninsurance and its effects are certainly a good thing, there are still considerable issues to address.

“[T]he number of people who remain without coverage is still intolerably high,” Zarr said. “And the Census Bureau report leaves entirely unmentioned the millions of people who have health insurance but who can’t afford to use it because of high deductibles and copays.”

In fact, nearly a quarter of all insured non-elderly adults are underinsured, Zarr added. Of these individuals, 44 percent have gone without a physician visit, medical test, or prescription due to an inability to afford the service.

The head of PNHP acknowledged that having expensive coverage is certainly better than having no coverage, and underscored the detrimental effects of having such a large population of uninsured or underinsured individuals.

Citing a study performed by the American Journal of Public Health, Zarr highlighted statistics regarding the potential effects not having health insurance can cause — that for every 1 million people who do not have health insurance, there are 1,000 deaths linked to that very issue.

“[T]he 33 million people the Census Bureau says were uninsured in 2014 means that approximately 33,000 people died needlessly last year because they couldn’t get access to timely and appropriate care,” Zarr said.

This issue of uninsured populations is also expected to continue. According to the Congressional Budget Office, approximately 27 million people are expected to be uninsured over the next 10 years. Even if all states were to adopt the Medicaid expansion policy within the ACA, there would still be a population of approximately 24 million uninsured individuals.

Zarr provided a possible solution to these health insurance woes: a single-payer, Medicare for all, healthcare system. He stated that a single-payer system could be the singular path toward providing universal healthcare, something he believes a nation with such great wealth should be able to provide its citizens.

“A single-payer system would achieve truly universal care, affordability, and effective cost control. It would put the interests of our patients — and our nation’s health — first,” Zarr said. “We need to move beyond the administratively wasteful, complex and inadequate ACA to a more fundamental, comprehensive single-payer national health program for all.”

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