Obamacare and the Uninsured

Whitehouse.govWhitehouse.govThe Obama administration has said that it is not "systematically" tracking information on how many previously uninsured people have gained health coverage thanks to Obamacare. And a recent change in the way that the Census tracks coverage rates means that, when that data is eventually released, we won’t be able to compare the new results to a multi-year baseline.

That means we have to rely on other sources of information. And for the moment, one of the best sources is Gallup’s tracking poll. As I noted back in March, the survey has shown drops in the national uninsurance rate since the beginning of the year, when Obamacare’s coverage expansion kicked in. When the drop first appeared early in the year, it was possible that it was just a result of month-to-month variation.

That’s not really plausible anymore. The latest update shows that the uninsurance rate has continued to drop over the last few months, hitting 13.4 percent—its lowest rate since 2008.

GallupGallup

After the botched launch of the exchanges last year, there was a lot of speculation—including from me!—about the possibility that, between the mass insurance cancellations caused by the law and the broken website, the law would actually result in a net loss of insurance coverage. That’s pretty clearly not what happened. 

It’s still possible that the data is not perfectly precise. We’ll know more as some of the official estimates come out over the next year. And these sorts of dramatic gains may be harder to sustain in future years: Presumably the people who signed up first are those most motivated, or most easy to motivate, to get coverage. But at this point it’s safe to say that Obamacare has helped reduce the ranks of the uninsured.

The survey does suggest some potential challenges for the health law going forward in terms of who is covered: It found increased coverage levels in all the under-65 age and ethnicity groups it measured, but the shift doesn’t look quite as strong among Hispanics and young adults, two groups that were heavily targeted by the administration.

Gallup doesn’t break out coverage by type, so we don’t know how the newly covered are getting their insurance. Presumably, some proportion are getting covered through Medicaid. And the best evidence we have about Medicaid, specifically, is that it doesn’t do much to improve measurable physical health. It’s basically a financial shock absorber.

Of course, as I noted with regards to the study I wrote about earlier today, which found a reduction in mortality in Massachusetts following the implementation of RomneyCare’s coverage expansion, it’s always helpful to compare any of these gains against their likely costs. Obamacare requires about $2 trillion in spending over the next decade. And, yes, that spending is supposed to be offset by a combination of tax hikes and reductions to Medicare spending, but even still, that’s $2 trillion that won’t be spent on something—or many somethings—else. Making policy choices is about more than finding a positive result and declaring success; it’s about comparing the results and the costs with the forgone opportunities.

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  • brec||

    Of course, as I noted with regards to ...

    Dear Scott,

    That should be "with regard to".

    Regards,

    brec

  • brec||

    Dear brec,

    It's polite to use the correct name of the person to whom you address a comment.

    Regards,

    brec

  • ||

    Given the mess of Obamacare's rollout, that one must pay to actually be insured, and the simple misunderstanding of the unread that the existence of Obamacare means they are automatically insured, are we sure the answers to the question "Do you have health insurance coverage?" are accurate?

  • Rasilio||

    Not to mention the number who went onto the exchange selected a plan and thought that meant they were covered

  • Tommy_Grand||

    I agree with the article in general, but given that it's now illegal to be uninsured, I suspect a decent number (e.g. 2%) of those polled by Gallup lied & falsely claimed to have insurance, fearful of incriminating themselves whenever the NSA listens to the recorded phone call.

  • mb||

    Since this is self reported and it is now against the law not to have insurance, I doubt these numbers.

  • Juice||

    Channeling a TN state senator, it's like the Nazis coming to your door asking how many Jews you have inside.

  • correctnotright||

    It is not illegal - there is a fine if you don't buy insurance. There is no danger of "admitting" this on a survey and the IRS will catch people who don't have proof of insurance anyways. Please stop spreading misinformation.

  • R C Dean||

    It is not illegal - there is a fine if you don't buy insurance.

    I think you are confused about what "illegal" (or possibly "fine") mean.

  • albo||

    Obamacare's gonna work and we'll all live forever and you libertardian Randites are going to be so jelly!!!!111

  • sarcasmic||

    Let's see. Most of these policies have a deductible ranging from three to eight thousand dollars, the policies cost upwards of ten grand a year, and only about half of what is charged actually goes against the deductible.

    So after paying ten grand for the policy, and anywhere from six to sixteen grand in health care, the insurance finally kicks in. That's every year.

    What a bargain!

  • Rasilio||

    This.

    Yes they are "covered" in that they have a policy that they (or the taxpayers, or some combination of the two) are making payments on but the reality of the situation is that they now have less disposable income to actually pay to see a doctor meaning all they really have is a VERY expensive catastrophic plan because in more than 95% of cases they could never reach the deductible in any given year (and even coming close to it would bankrupt them just as much a getting cancer would)

  • correctnotright||

    And these policies are, on average, better than what was available before.
    By the way, the average deductible is not anywhere near 8K - your numbers are way off. Maybe for the cheaper bronze plans for an entire family - but not for individuals on a gold plan, the average deductible is about $500-1,000.

    Of course, many of the older plans cost about the same before - but offered far worse overage (many of the plans had worthless coverage because their lifetime caps were so low).

  • Sheriff Bart||

    I just went on the ObamaCare website for my state. For my 17 year old son and I, the cheapest premium of $356/month comes with a $12,600 deductible. Another plan with a paltry $6,700 deductible costs $530/month.

    I would guess you are quoting someone who gets a load of subsidies judging from the rest of your misleading posts.

  • R C Dean||

    And these policies are, on average, better than what was available before.

    That's gonna need a cite.

  • Redmanfms||

    but not for individuals on a gold plan, the average deductible is about $500-1,000.

    Bullshit. It's closer to $1500 for individuals and near $2500 for families on the gold plan. Max OOP is in the $8000-$9000 range.

    Premiums are much higher than plans that offered similar deductibles, 50-75% higher.

    Of course, many of the older plans cost about the same before

    Bullshit.

    but offered far worse overage (many of the plans had worthless coverage because their lifetime caps were so low).

    Bullshit.

  • The Late P Brooks||

    The Obama administration has said that it is not "systematically" tracking information on how many previously uninsured people have gained health coverage thanks to Obamacare.

    Why the fuck would they do that? It's not like getting coverage for the uninsured was the (ostensible) primary goal of this entire fiasco.

  • WhatAboutBob||

    Obamacare is putting more people on Medicaid, which is a ticking time bomb for federal and state budgets. And it's been shown that people on Medicaid don't fare any better than those without insurance, plus it increases unnecessary ER use. There's so many things wrong with this law that anyone who still supports this law is either stupid and/or dishonest.

  • sarcasmic||

    The big debate in my state right now is over expanding Medicaid. The governor opposes it, so the Democrats are now claiming that 150 people will die as a result.

    That's right. Opposing the expansion of Medicaid is the same thing as killing people.

    Talk about stupid and dishonest. I'm sure Tony agrees.

  • albo||

    The PA House Democrats have a ticking clock showing how much money the state is "losing" by not expanding Medicaid.

    http://www.pahouse.com/

    So far it's close to a billion
    *face palm*

  • timb||

    I don't know about Tony, but I agree and you can look at the study released today to tell you what you already knew, i.e., people managing their diabetes and heart conditions as chronic illnesses rather than catastrophic strokes and kidney failures save us all money in the long term.

    To be fair, giving a sh*t about the long-term is not exactly a libertarian ideal.

  • correctnotright||

    Actually, if you read the report on Medicaid expansion in Oregon, they say that their results were short- term and not generalizable. So your statement is inaccurate.

  • Almanian!||

    You're the worst character EVER

  • Paul.||

    Obamacare is putting more people on Medicaid, which is a ticking time bomb for federal and state budgets.

    It's all a ticking time bomb.

  • R C Dean||

    Obamacare is putting more people on Medicaid,

    I suspect that's where the vast majority of that dip in the "uninsured" rate comes in. Even though Medicaid isn't insurance, its welfare.

  • flye||

    So Obamacare increased funding and eligibility for Medicaid, threw massive subsidies at another large segment of the population, and made it quasi-illegal to not have health insurance... and we're surprised that people claiming to be covered has gone up?

    I mean, getting more people covered is the one thing they can definitely point to as a positive. On the negative side: pretty much everything else.

  • KPres||

    How does forcing people to buy something they don't want count as a positive?

    The greatest myth of the whole Obamacare fiasco was that the 50 million uninsured were people who couldn't afford it. That was nonsense from the beginning. Only a small portion fit that description.

  • timb||

    Your data to back this up is?

    Just a hunch, answers KPres

  • correctnotright||

    Actually, you are wrong. The vast majority of the 50 million uninsured were low-income workers and those with preexisting conditions.
    http://kff.org/uninsured/fact-.....opulation/

    Also, there were 38 million who were under-insured by bogus policies.

  • Sheriff Bart||

    "Bogus policies"- straight out of the DNC playbook...also known as policies that met the needs of the insured who bought them instead of truly bogus policies loaded up with benefits an insured will never use.

  • Paul.||

    These bogus policies wouldn't be policies that didn't have, say, reproductive benefits or pediatric dentistry attached for an 57 yr old woman, would they?

  • timb||

    So, expanding Medicaid is bad?

    PS You should check out this new thing called the CBO, ''cause, like, dude, they don't exactly see what you dead-enders see

  • R C Dean||

    expanding Medicaid is bad

    Yup. Fiscally, because of the poor care Medicaid recipients tend to get, and because of the perverse incentives it (like any welfare program) creates.

  • WhatAboutBob||

    The Oregon study showed that Medicaid 'Had No Significant Effect' On Health Outcomes vs. Being Uninsured. So why is putting more people on Medicaid good?

  • Redmanfms||

    PS You should check out this new thing called the CBO, ''cause, like, dude, they don't exactly see what you dead-enders see

    The CBO, by charter, only sees what politicians tell it to see. They are required to make calculations based on the assumptions presented. The assumptions presented in the case of Obamacare were all bullshit.

    The fact that the CBO projections on the cost on the bill in 2009 fell far below the realized enrollment rates and costs should tell you something.

  • Juice||

    The Obama administration has said that it is not "systematically" tracking information on how many previously uninsured people have gained health coverage thanks to Obamacare.

    IOW, either the law wasn't actually designed to make sure uninsured people became insured or it was but they just don't care that much.

  • XM||

    If you count medicaid coverage as insurance coverage, then the uninurance rate has nowhere to go but down.

    It's not possible for the insurance side of the scheme to work if medicaid sucks in all the paying customers. States budgets will take a serious hit if million.

  • R C Dean||

    But at this point it’s safe to say that Obamacare has helped reduce the ranks of the uninsured.

    Yeah, big Medicaid expansions will do that.

    Best back-of-the-envelope calculation that I can do comes up with @ 1mm more people who have actual insurance now than they did before. That's a grand total of 20,000 per state.

    What. A. Massive. Success.

    And what kind of blithering idiots don't even try to measure the success of their signature program, anyway? And make sure no one else can, either, by changing the methodology?

  • ||

    And what kind of blithering idiots don't even try to measure the success of their signature program, anyway? And make sure no one else can, either, by changing the methodology?

    Yep. ^^^This.

    Shifting goalposts, although nothing new, is the latest fad.

  • INFORG||

    Is anyone factoring in the keeping of "kids" on parent policies until age 26 now? I know I have 2 adult kids that I keep on my insurance, even though they could get it on their own through employers. What is the point in them paying more when my family policy costs the same whether they are on it or not?

    This has to affect the numbers and is another reason why participation by young people in the exchanges seems below what was hoped for, since they can be covered through the parent.

    Do they really not see how these things are going to result in weird distortions and higher insurance costs?

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