A Few Questions About Obamacare and the Uninsured Rate


The good news for Obamacare supporters is that a monthly tracking poll from Gallup finds that the percentage of uninsured Americans dropped this month, the first in which Obamacare's major coverage provisions kicked in. The uninsured rate dropped from 17.3 percent down to 16.1 percent between December of 2013 and January of this year, according to the Gallup-Healthways Well-Being Index.  

The less-good news for the health law's backers is that the uninsurance rate is still essentially the same as it was in the early months of 2010, when the law passed. And it's still several points higher than it was late in 2008, just as the recession hit, and when President Obama finishing his first campaign.

Here's the graph:

The survey results leave a few unanswered questions:

How much of this month's result is just normal variation? There have been numerous large month-over-month spikes and drops in the numbers over the years, and this month's dip isn't far out of the normal range. While it's unlikely that normal variation explains the entirety of this month's drop, it may explain some or even most of it. 

What happened during the summer of 2013? The uninsured rate jumps all the way up to 18.6 percent, almost a point higher than its previous high, before it starts falling again in the second half of the year. 

How much of the expansion of insurance comes from Medicaid, and how much is in private insurance? The report doesn't attempt to break out the number of people who are insured through Medicaid, the federal-state program for the poor that was expanded under Obamacare. And federal data on Medicaid enrollments since October of last year isn't very helpful either, since it doesn't differentiate between people who renewed prior Medicaid coverage and people who are newly covered under the health law. But it would be interesting to know. In theory, it's still possible that the number of people with insurance of any kind (including Medicaid) has increased, but the number of people with private insurance has not. 

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  1. In theory, it's still possible that the number of people with insurance of any kind (including Medicaid) has increased, but the number of people with private insurance has not.

    If there was a way of showing that private insurance enrollment has increased in a meaningful way, I'm positive HHS and the Obama acolytes would be showing it.

    As it is, I predict they'll still tout this supposed increase, leaving out the context and certainly tip-toeing around the issue that Obamacare has mainly had the effect of increasing the welfare rolls.

    1. Yup. They will do that and also claim that the total number of insured is not a meaningful number anyway.

    2. " I predict they'll still tout this supposed increase, leaving out the context"

      In unrelated news, do you realize that Obama has cut the deficit in half since he took office?

      1. It's still OVER $300 BILLION more than the average was for Bush - not only that but he added $7 TRLLION to the DEBT!

    3. The numbers I've heard have been something like:

      4 - 6 million people had their policies cancelled at the end of last year.

      2.2 million people have obtained (in some meaning of the word) insurance through the exchanges. Most of those had insurance previously.

      So, no fucking way on earth do more people have insurance now than they did last year. More are on welfare, sure, but we shouldn't call them "insured". Because they aren't.

      1. And there are 800,000 more people every month.

  2. "In theory, it's still possible that the number of people with insurance of any kind (including Medicaid) has increased, but the number of people with private insurance has not."

    It is, in fact, likely that the ratio is reversed; hardly ever is a product offered for 'free' and at some sort of market rate where the market rate gets more buyers than the 'free' takers.

    1. But medicaid isn't free. You have to go through all kinds of hassles and bullshit if you are on it; things like make regular visits to a social worker. Most poor people were already getting their medical care for free buy just showing up at an emergency room. They are only signing up for medicare to avoid the penaltax and because some of them are too stupid to understand that it is not private insurance.

      1. There was an article in the most recent Downtown News (L.A.) talking about how the homeless on Skid Row aren't signing up for medicaid as part of Obamacare because they distrust the govt.

        1. You don't live on skid row because you are interested in getting help or showing up at appointments. They are not on medicaide because they are smart enough to know signing up might obligate them to do something.

        2. Imagine signing up for Medicaid and then having the social worker pop by for an unexpected visit and take your kids away when they notice the pot pipe on the table.

      2. John,
        That's the reason I qualified it with quotes. From the low-info point of view, it doesn't cost money, therefore it is "free".

      3. While many of the new enrollees might not be fully medicaid, I'm willing to bet the a significant percentage of the new enrollees are heavily subsizided

        1. I am sure t hey are. The only way it makes sense to enroll is if you are getting subsidies or have some horribly expensive and chronic pre-existing condition. Otherwise pay the penaltax and take your chances.

          1. Last I heard, there was no penalty for refusing to pay that penaltax.

            1. They, the IRS, takes it out of your Tax Refund. It's 1% of your earnings or $95 whichever is greater.

      4. So basically anyone who qualifies for Mediciad is now REQUIRED to enroll in it. Or pay a penalty.

        Compulsory Medicaid = compulsory visits to social workers.

        I bet there's a supreme court challenge in there.

        1. That is a interesting point Hazel.

        2. I bet there's a supreme court challenge in there.

          And I bet there's a 7-2 decision saying its perfectly okey-dokey.

        3. It's not a penalty - it's a tax.

          /John Roberts

          1. So you can be taxed for not visiting your local social worker?

  3. is teh penaltax prorated for people who join/ drop during the year?

    1. I think it is supposed to be. But color me skeptical that the IRS will have any way of enforcing that.

      And don't forget, thanks to the website fuck up, a ton of people think they have insurance but don't. Those people will be paying the penaltax. And so will other people who have insurance but for whatever reason the IRS doesn't show it on their records.

      1. ..."Those people will be paying the penaltax"...

        Unless Obo 1st rules in favor of changing the fixed laws.

        1. He might do that. But I am not so sure. If he waives the penaltax, he will be effectively repealing his own law. The insurance companies want their money. The political fallout from waiving it would be enormous. Of course the political fallout from fining people for not buying insurance that is unavailable is going to be pretty huge too. Either way, it should be entertaining.

          I think that anyone subject to the penaltax has a good equal protection and due process claim against it. The government can't fine you for failing to do something it has made impossible to do.

  4. So, who counts as an "American" in this statistic? If a bunch of illegals cross the border, does the number of uninsured go up? If they go back home, does it go down?

  5. This is almost certainly composed almost entirely of medicaid enrollments. And still it is a pretty puny effect. We're talking about less than 1% change here.

    And as I've pointed out before, that change probably includes nearly everyone who wanted health insurance and couldn't get it before. The hordes of people screaming for health insurance don't seem to have materialized. It turns out that most of the uninsured didn't really want health insurance or didn't want it at these prices.

    Which means, if they ever get the other 16% to sign up, that's going to be a 16-1 ratio of unhappy to happy customers.

  6. It turns out that most of the uninsured didn't really want health insurance or didn't want it at these prices.

    I would say the latter is probably the most likely scenario. I too want health insurance for free.

    1. I don't want health insurance.

  7. Only one thing has really been accomplished by Obamacare's price fixing - that high volume users of health care are being subsidized more heavily by everyone else.

    The heavy users have had their maximum cost (premiums plus deductible) go down while also ensuring the highest probability that they would receive benefits to pay for their care. Everyone else has seen their minimum costs (premiums) rise, and then with the also higher deductibles have a lower probability that they receive any benefits to cover their care.

  8. I just read this quote. It really shows you what type of person Obama is. He was being interviewed and asked if he should shmooze a bit more in order to get things done. Tip O'Neill's personal relationship with Ronald Reagan was raised as an example. He said he thought it might be a bit helpful, but added the following:

    "But had Tip O'Neill not seen it to be in his interests to do a deal with Ronald Reagan because he had a whole bunch of conservative and Southern Democrats whose districts had been won by Reagan ? and had Reagan not been looking at polls from his advisers telling him that Social Security was a very popular program and that he couldn't be seen as antagonistic toward it ? it wouldn't have mattered how many drinks Reagan and Tip O'Neill had together," he added.

    In other words he assumes all people make all decisions based on what is best for them politically. It doesn't seem to cross his mind Tip or Ron might actually vote for something because they believe in it.

  9. Is a person with a $5000 deductible who doesn't have $5000 to pay the 1st $5000 actually "insured" just because they have a blue Cross ID card?

    1. No, they're just out a lot of money and wondering where their insurance went.

      I thought those were called "junk plans" - you have to pay $10-$12k in premiums plus deductible before you get any benefits paid.

      Again, the poor and the sick get subsidized, while the rest get screwed.

  10. There is no law (yet) that forbids you from dickering over prices with service providers, like law services, plumbers and even doctors and hospitals. You get screwed because you think it's your lot.

  11. How To Opt Out Of Obamacare. Know your options and become savvy self-pay patients. Join a health care sharing ministry. These are voluntary, charitable membership organizations that agree to share medical bills among the membership. They function similar to insurance, and are probably the best alternative to conventional health insurance. There are four of them, at least that I know of. Three are open only to practicing Christians (Samaritan Ministries, Christian Healthcare Ministries, and Christian Care Ministry) while a fourth, Liberty HealthShare, is open to anyone who agrees with their ethical commitment to religious liberty. They operate entirely outside of Obamacare's regulations, and typically offer benefits for about half the cost of similar health insurance. Members are also exempt from having to pay the tax for being uninsured. From the article by Sean Parnell http://thefederalist. com/2013/12/04/opt-obamacare/#.Up9MwGKiM_o.email

  12. Will Obamacare be repealed or won't it? Will Congress fund it or won't it? Will the web site be fixed or not? Blah, blah, blah. We the people just need to do what we need to do and Congress be damned. Resist. Refuse. Revolt. EXEMPT OURSELVES! We did not comply with Prohibition and we simply should not comply with Obamacare. For religious reasons. For privacy reasons. For the cause of liberty and freedom and in protest of the idea that the federal government (under one party rule, no less), can force private citizens to purchase anything with our own money. Are we citizens or subjects? Mice or (wo)men? Just say NO to socialism and to the corrupt, unionized, far left IRS: the gestapo of America's political class. After all, the federal government ignores millions of illegals who are breaking U.S. immigration law every day. Our Founders pledged their lives, their fortunes and their sacred honor. All we have to do is just say no to a scheme we all know is un-American and a violation of our most basic founding fundamentals of privacy, self reliance, limited government and individual freedom.

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