Obamacare and the Uninsured, Redux


New survey data from Gallup is being hailed as confirmation that Obamacare is helping the uninsured get coverage.

It's essentially the same confirmation that we already had two months ago: The Gallup-Healthways Well-Being Index released today shows that the uninsured rate dropped to 13.4 percent this year, the lowest rate since the index was started in 2008. That's the same rate that Gallup found in April. The new survey data mostly confirms what we already knew, and suggests that coverage levels have flattened out. An additional survey from the Commonwealth Fund also estimates that about 9.5 million fewer people are uninsured following the law's coverage expansion, which is roughly in line with estimates from RAND and the Urban Institute

As I noted in May when previous Gallup numbers were published, it's safe to say that Obamacare has reduced the number of uninsured. By how much, exactly, is hard to say, although most estimates seem to suggest a reduction of 9-10 million. As Politico notes, the precise drop is still difficult to determine, and the numbers are still fuzzy and even contradictory (RAND, for example, found that the bulk of the decline came from a big rise in employer-sponsored coverage, which is odd, and complicates the argument for the primary components of Obamacare's coverage expansion). But the overall effect is clear: Millions of previously uninsured people now have some form of health coverage. 

In some sense, then, the health care debate has simply been reset to where it was in the years before Obamacare went fully live—before the exchanges launched so disastrously, before the sluggish early enrollment figures, and before the end-of-year wave of health plan cancellations. At that point, one thing that the large majority of observers, critics and supporters alike, agreed on, was that Obamacare would result in expanded health insurance coverage. 

The debate was over broader questions that proceeded from that assumption: Does the coverage provide benefits commensurate with its cost? Will there be unintended consequences, like longer lines, higher premiums, and runaway costs to the government? Is Obamacare's complex multi-part coverage scheme the best, most efficient, most effective way to improve the nation's health system? Despite some of the triumphant declarations that the new reports prove Obamacare is working, Obamacare isn't necessarily a success simply because it managed to expand coverage; that's one test, but it's not the only one. It also matters how that expansion is achieved and maintained, and at what cost, with what further consequences. 

Even the most precise coverage data won't resolve these sorts lingering questions. The debate over Obamacare will be with us for a long time to come. 

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  1. If those surveys conflate Medicaid with insurance, then they are bogus from the get-go.

    1. Precisely. IF 8m people “almost bought” policies on the exchanges, how does that translate to 10m additional people covered? It doesn’t.

      MedicAid is not insurance, it’s welfare. And many of those who “signed up for” private insurance already had (sometimes better) policies or never paid for the policy they selected.

    2. Precisely. IF 8m people “almost bought” policies on the exchanges, how does that translate to 10m additional people covered? It doesn’t.

      MedicAid is not insurance, it’s welfare. And many of those who “signed up for” private insurance already had (sometimes better) policies or never paid for the policy they selected.

  2. Clicked too soon. It would be the equivalent of counting Social Security recipients as having jobs.

  3. The debate will be with us – and it will be nothing but talk and small adjustments at the margins, ala Medicare, SS, Medicaid, farm bill, defense spending, QE, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc, etc…

  4. Alright, one more.

    Best estimates are that there are 3mm more people enrolled in Medicaid. Deduct that from the survey numbers, and we’re down to 7mm.

    We know from recent articles that the expansion in the individual market is no more than 2.5mm, probably less. So that leaves around 4.5mm expansion in, you guessed it, the employer market.

    Just like the RAND study said.

    1. Ten million people previously denied access to healthcare by their employers now enjoy premium coverage thanks to Obamacare!

    2. The funny thing is, ObamaCare contains only disincentives for employer coverage (at least, from the employer perspective, in the absence of the employer penaltax, which hasn’t gone into effect yet).

      At a minimum, that expansion would have happened anyway. More realistically, even more people would have employer-based insurance without ObamaCare.

  5. But what do Millenials? think about this?

    1. They have yet to develop the skill called ‘thinking’. That comes right before the death panels kick in.

    2. We’ll know in 2027, when the first Millenials turn 26.*

      *you know, if you think “millennial” should refer to someone born this side of 2001.

      1. Executive action can fix that problem, maybe 28? If the poll numbers call for it.

  6. Obamacare is great! Wait times have increased dramatically! Premiums are up! Deductibles are up, a lot! Share of insurance pay is down, way the fuck down!

    What is not to love about that! You just hate the president cause he’s black, you racist pigs!

    1. craiginmass assures me that wait times are decreasing rapidly. Why, it only took his friend a week to get an appointment.

      1. A week is fucking stellar, if he’s not lying. Maybe he got lucky.

        If you are lucky enough to have a primary care doctor that you have already seen and that accepts your insurance, it could be only a few days, or it may still be weeks.

        Good luck with a specialist, you will have to have PPO insurance or the wait will be unbelievable for a supposedly first world country. If you don’t, good luck, maybe you can go out of the country if you have the money, before you die of some undiagnosed misfortune.

        I know this shit because I do contact work for one of the largest healthcare providers in the USA. Craiginmass is probably just another lying leftist shithead, who makes up stuff based on what he thinks ‘should’ happen.

        Here’s the straight up. Wait times and availability of doctors has worsened alarmingly since Ocare took effect and it keeps getting worse.

        Premiums are up, but not that much, at least for me.

        Deductible are almost 10x what they were.

        What insurance pays… let me put it this way. I paid $50 for an x-ray of two feet 3 years ago, after insurance. A month ago, I paid $150 for the same, after insurance.

        Anyone who thinks this crap has made healthcare better is either getting a free ride, courtesy of us tax payers, or they live on another planet, in a different time, under a different law.

        1. Had a thing today. Had to take the niece in to Urgent Care for a lung problem. Doctor told me to take her to the ER — not as a medical measure, but as an administrative measure. Wait times are out of hand for an appointment with a pulmonologist who could check her over and send her down the hall for a CT scan. Wait, wasn’t Obamacare supposed to reduce ER use?

        2. Free enterprise, as usual, is the answer.
          Where I live, a doctor visit–no waiting for more than 15 minutes–costs as little as $2.25 at “Dr. Simi Clinics” (which even exist in some South American countries).

          All lab-tests, x-rays, most medicines require NO PRESCRIPTION.
          I had a double-cataract operation for $1400 including all tests and hospital stays-everything. A colonoscopy cost me $90. All this is WITHOUT insurance.
          I live in Mexico.

  7. As I’ve mentioned before, the fact that many people only signed up at the last minute means they were probably doing it to avoid the penalty, not because they needed insurance.

    1. It’s great when everyone pays their fair share. Wait… I wasn’t talking about me… I don’t want to pay for this, other people are supposed to! It’s not fair!


  8. Does the coverage provide benefits commensurate with its cost?

    If the ACA called for sacrificing 10,000 virgins each new moon in addition to the present exorbitant costs, progressives would continue to point to lower percentages of uninsured* Americans and trumpet the legislation as a success. They’ve never had any understanding of the opportunity costs of grand nationalist schemes, and they’ll continue to dig their heels in obstinately as the physician-patient ratio plummets and medical outcomes decline to the standards of every other social democracy.

    The robodoctors and nanotech can’t arrive too soon.

  9. Even if you take the 10mm at face value, there were 42-44 million uninsured at the beginning. The law wasn’t passed so we could cover 10 million. You could have added 10 million in Medicaid recipients with a better outreach and education program that would have cost a tenth of what the malfunctioning half a website cost.

    1. And not fucked up the insurance of the other ~280 million people in the country.

    2. Healthcare is a right! How dare you suggest that it isn’t!


    3. Even if you take the 10mm at face value

      I can think of a whole list of politicians connected to this law that should take a 10mm at face value.

  10. According to Gallup, Medicaid and Medicare are “Type of health insurance coverage.”

    Medicaid and medicare insurance coverage? I didn’t realize medicaid patients paid into a risk pool.

    Meanwhile, employer based coverage has actually slightly declined since 2009. If your boss drops your plan and you make enough money not to qualify for medicaid, you have to buy insurance. If you chose to forego coverage despite having the money to do so, you have to buy insurance now. Surprise!

    The sort of wretched, long term “uninsured” people the left had in mind are NOT buying healthcare. They’re going straight to medicaid. I was uninsured most of my life, and I applied for medicaid (Covered ca is still verifying residence, WTF). If you’re just giving me free stuff, I’ll take it. But surprise, two hospitals near my house don’t take medicaid patients. Our doctors are recommending some sort of PPP plan.

    There’s like 30 mil people in CA, and their medicaid patients probably tripled. You have more people entitled to treatment, the but quality and quantity of healthcare has not grown proportionally. Good luck.

  11. More people are covered ( I am skeptical, but never mind that) but what will the quality of medical care be?

    Since this was never actually about medical care, I am gonna guess the quality of care is going to go in the shitter.

  12. Having health insurance has jack all to do with being able to see a doctor. My daughter’s friend needs gall bladder surgery. She has health insurance, however the deductible is in the $3 grand range. I don’t think this woman has ever had 3 grand all at once in her life. No surgeon around here will even put you on the schedule until you’ve paid the surgical deposit (i.e. what won’t be covered by the insurance) so no surgery for her until an ER doc is forced to do it.

    1. But Obamacare reduces ER usage!

      (See my comment above for further confirmation.)

    2. In most advanced countries in the world, she’s get her surgery with little-to-no deductible. But not here, not with the ACA.

      Hope the delay dosen’t harm her permanently.

  13. Welfare recipients have dropped precipitously.

    People on disability has skyrocketed.

  14. But global warming

  15. For the children

    1. An historic chance for our First Woman President.

  16. Ithink its gonna be a good ole one two three step.


  17. As long as Obamacare supporters can claim that there are ANY fewer people that are uninsured now (for WHATEVER reason) they can do a celebratory dance and spike the ball. And they will. That’s how politics works.

  18. Being able to get health insurance for the first time in 10 years, despite pre-existing conditions, has changed my life, much for the better.

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