Anniston Star, The
(AL)
May 10, 2018
May 10--Health
insurance coverage growth in the years under the federal Affordable Care Act
has begun to shrink, a new study shows.
The study
attributes the decline mainly to the President Donald Trump administration's
attempts last year to undermine the ACA, generally referred to as Obamacare.
The drop is greatest in states like Alabama that never expanded Medicaid as
part of the ACA -- a drop some area hospital and clinic operators say they've
seen this year.
"It's been
going on at least a year," said Wayne Rowe, CEO of Quality of Life Health
Services, which manages health clinics that provide primary care to the poor in
Calhoun and 12 other counties. "And more uninsured means a greater strain
on our resources."
The study,
published by The Commonwealth Fund, is based on a national survey that tracks
insurance coverage rates among 19-to-64-year-olds. The Commonwealth Fund,
headed by a former Obama administration official, is a New York-based national
foundation that promotes health care improvement.
The study shows
that the uninsured rate among working-age people is currently at 15.5 percent,
up from 12.7 percent in 2016. That means an estimated 4 million people lost
coverage.
For states like
Alabama that did not expand Medicaid, the uninsured rate among those of working
age rose more to 21.9 percent.
The study states
growth in the uninsured can be traced back to actions the Trump administration
took last year. Those include deep cuts in advertising and outreach during the
marketplace open enrollment periods and shorting of those enrollment periods.
Rowe said his
clinics have seen a 14 percent increase in uninsured patients in 2017 compared
to 2016.
"That's a
sizeable jump," Rowe said.
Rowe said his
clinics have a sliding fee scale for the uninsured that's based on income.
"They apply
for discount services," Rowe said. "But we see all patients
regardless of their ability to pay."
Koko Mackin,
spokeswoman for Blue Cross and Blue Shield of Alabama, the state's top private
health insurer, said enrollment has dropped this year for the company's health
care plans in the ACA marketplace. Under the ACA, Americans who meet income
requirements can buy tax-subsidized health care plans.
"This year our
marketplace enrollment is down slightly from last year, but is 15 percent
higher than our original 2014 enrollment," Mackin said, referring to the
start of the marketplace.
Mackin noted that
enrollment in the marketplace has fluctuated some over the years since 2014.
Dr. Will Ferniany,
CEO of the UAB Health System, said the Birmingham hospital has seen a rise in
uninsured patients that could be partially attributed to changes with the ACA.
According to UAB, its projected charity, uncompensated care costs are up 14
percent in the 2018 fiscal year over the 2017 fiscal year.
"One trend is
the ACA," Ferniany said of why costs are rising. "The other trend is
increase in high-deductible plans ... more and more employers are moving toward
high deductible plans, and a lot of Americans can't afford the deductibles."
Jim Carnes, policy
director for Alabama Arise, a nonprofit that advocates for people in poverty,
said the ACA has been beneficial for residents, noting that around 170,000
Alabamians have gained coverage in the marketplace. Any decline in insurance
rates would be harmful to poorer Alabama families, Carnes said.
"That's not a
trend that I'd be happy to see," he said.
Donald Williamson,
CEO of the Alabama Hospital Association, said he'd seen the study and wasn't
surprised by its results.
Williamson said the
gains made by the ACA took more of the cost burden off of hospitals. Any
increase in the uninsured would mean higher costs for Alabama hospitals, many
of which operate on tight budgets.
"More insured
reduces uncompensated care and bad debt and that helps hospitals, especially
those that are financially strained," Williamson said.
Staff writer Patrick McCreless: 256-235-3561. On Twitter
@PMcCreless_Star.
___
(c)2018 The
Anniston Star (Anniston, Ala.)
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Star (Anniston, Ala.) at www.annistonstar.com
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