Consumer Health News Dennis Thompson, HealthDay Reporter August 30, 2018
WEDNESDAY, Aug. 29,
2018 (HealthDay News) -- Health insurance coverage rates have held steady in
the United States, despite continued commotion over the future of the
Affordable Care Act, a new government report shows.
About 28.3 million
Americans were uninsured during the first quarter of 2018 -- not significantly
different than 2017, and 20.3 million fewer than in 2010, before the health
insurance reform law (often called Obamacare) was passed.
"Things are
relatively stable. During a time with a lot of uncertainty -- there's been a
lot of political turmoil over what will or won't happen with Obamacare -- these
gains we've made in reducing the number of uninsured have held pretty
steady," said health economist Ellen Meara. She is a professor with the
Dartmouth Institute for Health Policy & Clinical Practice, and was not
involved with the new report.
About 8.3 million
Americans now carry health insurance plans purchased through an Obamacare
state-based marketplace, according to the U.S. Centers for Disease Control and
Prevention's National Center for Health Statistics (NCHS).
Millions more are
covered under the Affordable Care Act's expansion of Medicaid.
In Medicaid
expansion states, the percentage of uninsured adults has decreased from 18.4
percent in 2013 to 8.7 percent this year, the report found.
But in states that
haven't expanded Medicaid, there's been a slight uptick in the uninsured, from
17.5 percent in 2015 to 18.4 percent in early 2018.
The NCHS report,
"Health Insurance Coverage: Early Release of Estimates From the National
Health Interview Survey, January-March 2018," was published Aug. 29.
Claire McAndrew is
director of campaigns and partnership at Families USA, a health care consumer
advocacy group. "People fare better in terms of access to coverage if
their state has expanded Medicaid," she said.
"The fact that
the poor and near-poor still remain disproportionately uninsured really points
to the need for states that have not yet expanded Medicaid to do so,"
McAndrew added.
The numbers show
that actions taken by President Donald Trump have not yet resulted in the
undermining of Obamacare, McAndrew and Meara said.
These actions
include expanding the sale of cheap plans that can deny coverage to people with
pre-existing conditions; cutbacks in funding to promote open enrollment and
assist people in buying insurance; and reductions to cost-sharing payments to
insurance companies, the experts said.
The Trump
administration has failed to set enrollment targets for health insurance
exchanges, eliminated funding for TV ads promoting the open-enrollment period,
and initiated deep cuts into enrollment counseling programs, the nonpartisan
congressional watchdog Government Accountability Office (GAO) said in a report
issued last week.
Trump also forced
insurers to increase premiums when he canceled payments under the Affordable
Care Act that reimburse insurance companies for lower deductibles and co-pays
to low-income customers, the GAO reported.
"People want
health insurance. They've become accustomed to the consumer protections and
financial assistance available to them," McAndrew said. "Even though
the Trump administration has been doing work to undermine health coverage,
people still are fortunately getting coverage and care."
There are some
troubling trends within the numbers, however.
The percentage of
adults with high-deductible health plans increased from 43.7 percent in 2017 to
47 percent this year, according to the report.
McAndrew said this
trend "indicates a need to get health care costs under control."
Rising costs of prescription drugs and medical services are driving up
premiums, forcing people to buy skimpier plans.
Unfortunately,
Meara said, these high-deductible plans force people to choose whether to seek
care for what might be a life-threatening medical emergency.
"The idea
behind these plans is that people are going to be savvy consumers, and we've
seen again and again that they aren't," Meara said.
"The idea was
they won't use a high-priced emergency department because they have a sore
throat or a cold, because it would discourage that. Well, it does discourage
that, but it also discourages seeking care where we think it's actually
needed," she explained.
Although insured
numbers are stable now, Meara and McAndrew said they are interested in what
will happen next year as the Trump administration continues to chip away at
Obamacare.
For example, next
year the individual mandate will end, a result of the Republican tax reform
law, Meara noted. People will no longer be required to have health insurance,
which could undermine the financial stability of the insurance marketplaces.
"We will all
be very interested to see what's going to happen in terms of insurance
coverage," Meara said. "Will they head to the exchanges in lower
numbers than before? I do expect we may see things reversing a bit."
https://insurancenewsnet.com/oarticle/obamacare-enrollee-numbers-arent-falling-report
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