The coverage of the uninsured has plateaued

Health Insurance Coverage in the United States: 2017

By Edward R. Berchick, Emily Hood, and Jessica C. Barnett
United States Census Bureau, Current Population Survey Annual Social and Economic Supplement (CPS ASEC), September 2018

In 2017, 8.8 percent of people, or 28.5 million, did not have health insurance at any point during the year. The uninsured rate and number of uninsured in 2017 were not statistically different from 2016 (8.8 percent or 28.1 million).



By Don McCanne, M.D.

This definitive report on the health insurance status of U.S. residents provides an extensive breakdown of the statistics on insurance coverage, but the one highlight above pretty well summarizes the status. There was no statistically significant change in the numbers of uninsured between 2016 and 2017.

Although the reported change from 28.1 million to 28.5 million uninsured may not be statistically significant, there are likely 400,000 people out there who personally believe it is significant for themselves even if the statistical analysis is dismissive of it. At any rate, there are still over 28 million people who can't be pleased with their lack of insurance coverage.

The major lesson in this report is that the gain from the Affordable Care Act has appeared to plateau, although the numbers may not have fully stabilized yet, largely because of the policies being adopted by the Trump administration and the various state governments. But it is safe to say that complete elimination of uninsurance is not imminent and cannot possibly occur without a major policy change.

One of the least promising policy changes would be a Medicare public option, or Medicare buy-in, which some have mislabeled as Medicare for All. It would provide only one more option in the market of plans that already exists and thus would have very little impact on overall coverage or affordability since the other options are already available.

Of course, the most promising policy change under consideration that would be fully effective would be a single payer national health program - a bona fide Improved Medicare for All.

It has now been a decade since we started down the path of Obamacare. Regarding the goals of universality, equity, affordability, administrative efficiency, and guaranteed lifetime coverage, it is clear that the Affordable Care Act has been a failure. Rather than merely adding a Medicare Advantage-like public option to our expensive but mediocre system, we should finally provide the fix our system truly needs - an Improved Medicare for All. Just make sure it's the real thing.

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