The Truth About Health Insurance Coverage Since Passage of Obamacare

In recent days the Administration and much of the press have trumpeted the rising percentage of young people, below 26 years old, who now have health insurance coverage.  Specifically, the Department of Health and Human Services press release asserts:

The Affordable Care Act allows children to remain on their parents’ health insurance plans until age 26.  This policy took effect for insurance plan renewals beginning on September 23, 2010, and was designed to address the fact that young adults are the age group least likely to have health insurance.  This is one of the important early provisions in the Affordable Care Act designed to expand insurance coverage to uninsured Americans.
New results released today by the National Center for Health Statistics show that this policy has had a significant impact on improving insurance coverage among young adults. Data from the National Health Interview Survey (NHIS) show that in the first quarter of 2011, the percentage of adults between the ages of 19 and 25 with health insurance increased to 69.6%, from 66.1% in 2010.[1]  This 3.5 percentage-point increase represents approximately one million additional young adults with insurance.

That is true as far as it goes.  However, the same press release provides additional data from the survey that shows that during the same period, health coverage for people ages 26 - 64 has shrunken dramatically.  Here is the chart they provide:

The trends lines are moving together.  The added health support of young people under 26 is likely to have maxed out since most parents were advised of the changes in the law and took advantage of it in the first year.  The only ongoing variable is likely to be the changing number of this age cohort in the population.

In fact, as reported by Gallup itself, although not mentioned in the HHS press release:

The percentage of uninsured 26- to 64-year-olds, however, continues to increase, rising to a high of 19.9% in the second quarter of this year. Among all Americans, 17.4% reported being uninsured in the second quarter of the year.

Another chart accompanying their report shows this drop in the numbers of people reporting that they have health insurance.

So, what we have is a reality in which the much ballyhooed 40 million Americans without health insurance before Obamacare has now become some number north of 40 million.  The net effect of Obamacare to date is therefore to have, arguably, only slowed the continuing shrinkage in the number of Americans with no health insurance.  Not yet worth celebrating.  And given the legal challenges to the mandatory coverage provisions of the law, the future doesn't bode well for improvement in these numbers.

Trouble On The Horizon For Medical "Reform"

"House Speaker Nancy Pelosi is “the mother of health care,” Vice President Joe Biden proclaimed Monday", according to the Washington Post.

 Well, that sort of bravado will no doubt play well on the Democratic chicken dinner circuit.  But sooner or later the realities of the new "Obamacare" legislation will be obvious.  Mostly the chickens will come home to roost by about 2014, well after the next presidential elections.  Until then, those who crafted this budget busting legislation will have to hope that a stiff upper lip will help them survive the next electoral round, which, after all, is the most any of them, regardless of party, ever contemplate.

In a very prescient piece in the Washington Post, Robert Samuelson reports on the findings of an Urban Institute study of the outcomes of the Massachusetts health reform effort, which looks very much like the stew crafted (as in witch crafted) by the President and the Democrats in Congress.

Read it and weep:

People have more access to treatment, though changes are small. In 2006, 87 percent of the non-elderly had a "usual source of care," presumably a doctor or clinic, Long and Stockley note in the journal Health Affairs. By 2009, that was 89.9 percent. In 2006, 70.9 percent received "preventive care"; in 2009, that was 77.7 percent. Out-of-pocket costs were less burdensome.

But much didn't change. Emergency rooms remain as crowded as ever; about a third of the non-elderly go at least once a year, and half their visits involve "non-emergency conditions." As for improvements in health, most probably lie in the future. "Many of the uninsured were young and healthy," writes Long. Their "expected gains in health status" would be mostly long-term. Finally -- and most important -- health costs continue to soar.

Yes, some of the young and healthy who have traditionally been uninsured will possibly seek medical attention that will uncover chronic diseases like hypertension and diabetes.  But will the numbers who avail themselves of this newly available care be so tiny as to have virtually no financial impact on their need for care later in life?  Look at the example of those who use emergency rooms for a form of primary care.  Many of them had Medicaid before yet continued the habits and inclinations of a lifetime.  People tend to act in their own self interest, not in what may in fact be the rational manner viewed as obvious by academics.  They do what offers them the percieved path of least resistance.  This is one of the major realities that will prevent  the anticipated savings from accruing as predicted.

Nor did anyone in the recent debates over medical reform even raise the problem of fee for service medicine.  It is as hot a potato as cutting Medicare benefits for seniors.  It will never happen in the 2 - 4 year life cycles of our politicians.   At least not till we are all staring  over the edge of a massive debt crisis that forces painful cuts and tax increases.