By Shefali Luthra November
21, 2019
“160
million people like their private insurance.” Former
Vice President Joe Biden in comments during the November Democratic
presidential primary debate
This
fact check was produced in partnership with PolitiFact.
Articulating
his proposal for health care reform, former Vice President Joe Biden emphasized
the number of Americans who, he said, were more than perfectly satisfied with
the coverage they have.
“One
hundred sixty million people like their private insurance,” Biden said during
the November Democratic presidential primary debate.
That
argument is at the heart of many moderate Democrats’ criticism of the “Medicare
for All” proposal backed by Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren
(D-Mass.). We decided to take a closer look.
We
reached out to the Biden campaign for comment. The campaign directed us to his
next point — that people who don’t like their private coverage could, under his
health plan, opt into government-sponsored coverage.
160
Million, And Some Squishy Polling
The
figure appears to refer to the number of Americans who receive health benefits
through work — so-called employer-sponsored health insurance. Under Medicare
for All that would no longer be an option.
On
first blush, polling seems to suggest that most people with employer-sponsored
coverage like it.
Polling
done earlier this year by the
Kaiser Family Foundation with the Los Angeles Times found that most
beneficiaries are “generally satisfied” with this insurance. (Kaiser Health
News is an editorially independent program of the foundation.)
But
that doesn’t get at the whole story.
“Most
like their policy, but not all,” said Robert Blendon, a health care pollster at
Harvard T.H. Chan School of Public Health.
The context
matters.
In the
same KFF/L.A. Times poll, about 40% of people with employer-sponsored coverage
said they had trouble paying medical bills, out-of-pocket costs or premiums.
About half indicated going without or delaying health care because — even with
this coverage — it was unaffordable. And about 17% reported making “difficult
sacrifices” to pay for health care.
Beneficiaries
who have higher-deductible plans — that is, they are required to pay larger
sums of out-of-pocket before health coverage kicks in — are also less likely to
be happy with their coverage, and more likely to report problems paying for
health care.
And
it’s also worth noting that these high-deductible plans have grown increasingly common,
even for the 160 million Americans who get insurance from work, though that trend may now be losing steam.
Research from the Commonwealth Fund,
meanwhile, notes that increasing numbers of “underinsured” people do, in fact,
have employer-sponsored health insurance. Underinsured people are those who have
coverage but delay care because they still can’t afford it.
Meanwhile,
other polling, such as a January Gallup survey,
suggests that about 7 in 10 Americans believe the nation’s health care system
is in crisis.
So
while Americans may individually not express frustration with their specific
private plans, more are learning that, when they try to use that coverage, it
doesn’t meet their health needs.
Sources:
“Underinsured Rate Rose From 2014-2018, With Greatest Growth Among People
in Employer Health Plans,” The Commonwealth Fund, Feb. 7, 2019.
“Seven in 10 Maintain Negative View of U.S. Healthcare System,”
Gallup, Jan. 14, 2019.
“Kaiser Family Foundation/LA Times Survey Of Adults With
Employer-Sponsored Insurance,” KFF, May 2, 2019.
“2019 Employer Health Benefits Survey,” KFF, Sep. 25,
2019.
“Access and Coverage: High Deductible Plans,” Peterson-KFF
Health System Tracker, Nov. 20, 2019.
Email
interview with Robert Blendon, Richard L. Menschel Professor and Senior
Associate Dean for Policy Translation and Leadership Development, Harvard T.H.
Chan School of Public Health, Nov. 20, 2019.
These
findings cast significant shade on the idea that all 160 million Americans with
employer-sponsored coverage actually like it.
Our
Ruling
Biden
argued that “160 million people like their private insurance.”
A
cursory look at polling would suggest that most of the people he’s talking
about — Americans who get coverage through work — are happy with their plans.
But
once you dig a little deeper, that narrative gets more complicated. Even while
Americans say they like their plans, large proportions indicate that the
private coverage they have still leaves meaningful gaps, requiring them to skip
or delay health care because they cannot afford it.
Biden’s
argument is technically correct, but it leaves out important context and
relies on a somewhat squishy number. We rate it Half True.
Shefali
Luthra: ShefaliL@kff.org,
@Shefalil
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