By Jenny Deam
Updated 8:46 pm, Monday, May 14, 2018
The historic gains in
Texas and the rest of the nation are now slipping away as the uninsured rate
starts to rise again, a new national health care report has found.
The rate of working age
adults without health coverage — those between age 19 and 64 — has ticked up to
about 15.5 percent so far in 2018, up from 12.7 percent in 2016, according to
the latest Commonwealth Fund tracking survey released this month.
That translates to about
4 million people nationwide once covered who no longer are insured, the survey
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“This is not an insignificant change,” said
Sara Collins, an economist and vice president for health care coverage and
access at Commonwealth, a New York-based private health policy foundation.
“What’s important is the direction it is going.”
And for those who were
heartened by the success of the 2010 health care law known as “Obamacare” in
insuring those who did without, that trajectory is headed the wrong way.
“Sadly, recent actions
by Congress and the administration to repeal, defund or weaken the Affordable
Care Act, the Children’s Health Insurance Program, Medicaid, and other avenues
of health coverage hurt all Americans. Texas is particularly vulnerable to the
erosion of health coverage,” said Ken Janda, president and CEO of Houston-based
insurer Community Health Choice.
Texas continues to lead
the nation in the rate and number of uninsured, according to health statistics.
About 4.5 million people in the state are uninsured, including nearly 700,000
children.
While the Commonwealth
survey did not specifically break out current erosions in Texas, the data
showed that the biggest reversals were happening in the South, in
Republican-led states, and in the 19 states that did not expand Medicaid. Texas
is three for three.
Still, not everyone sees
the report as necessarily grim.
Dr. Deane Waldman,
director for Health Care Policy at the right-leaning Texas Public Policy
Foundation and a retired pediatric cardiologist, maintains that uninsured rates
grab headlines but do not tell the whole story. He said on Monday he would only
be concerned if a spike in uninsured rates translates into a reduction in care,
but the two are not always linked.
Waldman and other
critics have long complained “Obamacare” creates bureaucratic bloat and is
unduly restrictive on types of affordable coverage available. He applauds the
action by Congress late last year to remove the penalty next year for those who
choose not to buy coverage which he believes will promote a free market
solution to the nation’s health care problems.
The Commonwealth survey
found that roughly 5 percent of insured adults will probably drop coverage once
the repeal of the individual mandate’s penalty goes into effect next year.
“They made that sound
like a bad thing. I don’t see that as a negative at all,” he said, calling the
mandate “government coercion.”
Under the ACA, the
individual mandate was considered a necessary pillar to help broaden the risk
pool. The idea was that if everyone, including those who did not use much
health care, were required to buy broad coverage it would help offset the cost
to cover those who were sicker and needed more treatment.
The national uninsured
rate prior to Obamacare was about 16 percent. The situation was even more dire
in Texas when more than one in four people — by some estimates as many as 26
percent — lacked coverage, according to data from the U.S. Census Bureau.
But by last year as the
law entered its seventh year the national rate had dropped to a historic low of
around 9 percent nationally and around 17 percent in Texas.
The new survey found a
nearly 6 percent rise in the number of working-age adults who lacked insurance
in non-expansion states, climbing to 21.9 percent in 2018 from 16.1 percent in
2016.
There was a similar 6
percent rise in states where adults identify as Republicans, increasing to 13.9
percent this year. For those who said they were Democrats the rate of uninsured
stayed steady at about 9 percent.
And about one in five
adults, or about 20 percent, living in the South are now uninsured, the survey
found.
“We’re already seeing a
decline in the substantial gains in Texas,” said Joe Ibarra, a member of Get
Covered Texas, a grassroots organization helping enroll people for health
coverage in the state.
He said the overheated
rhetoric that has surrounded the law from its beginning only contributes to the
confusion people feel. And while the majority of the law’s provisions remain in
effect, many now believe it has been repealed, which only makes it harder to
enroll people in coverage.
Last year the Trump
administration rolled out of series of actions that were seen as sabotage to
the ACA, including shortening the enrollment period by half, dramatically
reducing funds used in reaching those eligible for coverage, slashing the
advertising budget and promoting a series of testimonials from people who said
they were harmed by the law. The president has also erroneously stated that the
law has been eliminated.
“Absolutely I’m
worried,” said Ibarra. “If those numbers shoot back up the overall health of an
entire community is going to go down.”
jenny.deam@chron.com
twitter.com/jenny_deam
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