Number of uninsured U.S. adults hits four-year high

[dcsports]

The problem is that's easy to say but no one in the GOP (or anywhere else) has come up with anything like that promised alternative. It's like a healthcare unicorn.

The rest of the world deals with it by insuring everyone from birth to death, so the concept of 'pre-existing condition' doesn't really even exist. Everyone has always been covered, so there's no gaming of the system.

No system is perfect, and there is definitely a lot of 'the grass is greener' syndrome from many on the left. It's difficult to have a reasoned discussion with people who insist that 'single payor' will solve all problems.

But in this case, we aren't talking about ripping out the system and installing a new one.


Democrats weren't interested in working with Republicans. Period. They own what happened. Republicans offered a number of suggestions to help contain costs and expand the number of covered individuals. Many conservatives have proposed expanding the availability of health savings accounts and catastrophic plans. Expanding state sponsored risk pool insurance would have helped with the pre-existing insurance concerns. Expanding Medicare/Medicaid could have been done without gutting the market for private insurance. Doing nothing would have been better. It all fell on deaf ears.

 

[dcsports]

The VAST majority of people on private insurance (and what would include those on ACA plans now) got their insurance from work and the ACA did little to change that. It expanded the already existing Medicaid program. The big changes were to private, non-employer insurance, which is small share of the total healthcare market. So I have no idea what you're talking about when you say the ACA "gutted" the system.

I'll be more specific then.

Most people are covered through their employer, and in some cases associations. These are called group insurance. These plans were impacted, and it drove up costs, but in most cases these effects were shrugged off.

Millions of people purchased private insurance, individual insurance plans. This is where an individual or family purchases insurance directly with the insurance company. This is the market that was devastated. Old plans all but wiped out, and prices pushed through the ceiling. Millions who were happy with their coverage lost it, or could not afford the new plans.

 

[dcsports]

Repealing the mandate has resulted in higher premiums, as it was predicted it would.

Putting the Obamacare plans in place caused the premiums to skyrocket, as predicted.

 

[year2late]

wait i thought the ACA was supposed to end this and costs were supposed to go down not up?
the ACA was a failure from the start and obama owns this failure not trump but then again facts don't
seem to matter to you.

TDS failure.

You are right, we do need single payer. We need to get greedy health insurance companies out of the mix.

I never thought Obamacare was any solution. It was a foot in the door. It put coverage of pre-existing conditions in the forefront.

 

[TU Curmudgeon]

Gosh, wonder why the entire rest of the industrialized world went to some version of UHC? It's a f'ing mystery!

If you ask the question "What is the most cost/effective way of financing a medical insurance program that covers the highest percentage of the population possible for the greatest number of conditions possible?" you get one answer.

If you ask the question "What is the most cost/effective way of financing a medical insurance program that requires the lowest payouts possible and returns the highest level of profit possible?" you get a different answer.

There isn't a single private, for profit, insurance company in the world that wouldn't be absolutely overjoyed to take over 100% of all of the existing "government medical insurance" programs in the US - PROVIDED that they were allowed to add their current levels of profits onto whatever the American governments are already paying.

 

[JasperL]

No system is perfect, and there is definitely a lot of 'the grass is greener' syndrome from many on the left. It's difficult to have a reasoned discussion with people who insist that 'single payor' will solve all problems.

I never said it would solve all problems, just the specific problem I addressed in that post - the pre-existing condition problem.

But in this case, we aren't talking about ripping out the system and installing a new one.

We didn't rip out the system. Don't talk nonsense. The big changes were to private, non-employer plans, which is about 10% or so of the total insured.

Democrats weren't interested in working with Republicans. Period. They own what happened. Republicans offered a number of suggestions to help contain costs and expand the number of covered individuals. Many conservatives have proposed expanding the availability of health savings accounts and catastrophic plans. Expanding state sponsored risk pool insurance would have helped with the pre-existing insurance concerns. Expanding Medicare/Medicaid could have been done without gutting the market for private insurance. Doing nothing would have been better. It all fell on deaf ears.

OK, when/where have state sponsored risk pools worked? I am pretty sure the answer is never and nowhere, but I'm willing to listen. The problem is obvious - if you give insurers a dumping ground for those with pre-existing conditions funded by taxpayers, they'll find a way to dump them, because that's how they make the most money.

 

[JasperL]

I'll be more specific then.

Most people are covered through their employer, and in some cases associations. These are called group insurance. These plans were impacted, and it drove up costs, but in most cases these effects were shrugged off.

Be specific - how did changes to the employer based market "gut" that part of our system? What changes do you consider a "gutting" of employer based insurance pre-ACA? "Impacted" is one thing - of course they were "impacted"- but that's not what you're arguing.

Millions of people purchased private insurance, individual insurance plans. This is where an individual or family purchases insurance directly with the insurance company. This is the market that was devastated. Old plans all but wiped out, and prices pushed through the ceiling. Millions who were happy with their coverage lost it, or could not afford the new plans.

Again, we can argue whether this was a "gutting" of that market or not, but it's roughly 10% of those with insurance. You've not addressed the 90% who didn't get insurance in the private market. Did ACA "gut" Medicare? Medicaid (which was expanded)? VA?

And no matter what you think, there's no credible argument that the non-employer market was anything but broken pre-ACA, and with the ACA subsidies the number insured in this market grew, not shrank, and millions of people uninsurable pre-ACA because of pre-existing conditions are now insurable and insured so I'm not sure how that's a devastation of the private market.

It's absolutely true that the impact on some significant share of the non-poor who bought off the private market were at least arguably made worse off because of the increase in premiums, but then you should limit your critique to the impacts on that group and not generalize this share of 10% of the population as a "gutting" of health insurance in the U.S.

 

[apdst]

Maybe Congress should pass a law that fixes this. Oh, wait...

 

[Barnacle]

The good thing is for employer plans the maximum exclusion period for pre-existing conditions is a year, as I recall, and I'm long past it.

What's a little frustrating about the debate is everyone on the right loves their employer plan. Republicans also love their Medicare, especially the large senior bloc in the GOP. What do those have in common? Protections in the law for those with pre-existing conditions. As does the VA, and Medicaid.

And yet when we try to extend those same pre-existing protections to the piece of the market that is the non-employer private market, and the only place insurers are allowed to use pre-existing conditions to deny coverage or deny policies or exclude treatments for that recurring cancer or whatever, they pretend it's impossible to do without wrecking the system, while enjoying and celebrating the existing systems in the U.S. that work for individuals and that have protections in place for their cancer, or heart disease, or diabetes, and the same protections for their families.

And they smugly condemn the way ACA handled it while promising this unicorn of an alternative that works better but that hasn't been seen in this reality, anywhere, except as some version of 'universal' care which is how employer plans, Medicare, VA and Medicaid work - they're "universal" for that population.

Gosh, wonder why the entire rest of the industrialized world went to some version of UHC? It's a f'ing mystery!

No mystery to me at all.

None of them have 50 - sort of independent - states with their own funding (to a certain degree) , 50 governors and 100 senators who can "make" serious laws that apply to their state only ... like for instance death penalty ... or lighter ones, like speed limit.

There is no other nation in this world that is comparable to the US of A.

 

[Higgins86]

I was always under the impression that Obama wanted his bill to be just the beginning and that it was meant to be built on by following administrations. Guessing that hasn’t happened?

 

[LetsGoBrandon]

From United Press International

Number of uninsured U.S. adults hits four-year high
​

Jan. 23 (UPI) -- Roughly 13.7 percent of U.S. adults went without medical insurance in the fourth quarter of 2018, the highest rate since before the Affordable Care Act made took effect in 2014, a new Gallup poll found.

An estimated 7 million more adults are without health insurance now versus 2016 when the rate of uninsured dropped to a new low of 10.9 percent. Gallup collected data as part of the National Health and Well-Being index, which surveyed 28,000 adults per quarter in 2018. Respondents were asked if they have health coverage.

There are a number of factors that could be contributing to the decline, Gallup said.

"One may be an increase in the rates of insurance premiums in many states for some of the more popular ACA Insurance plans in 2018," Gallup said. "For enrollees with incomes that do not qualify for government subsidies, the resulting hike in rates could have had the effect of driving them out of the marketplace."

COMMENT:-

Another "Obama Era" landmark smashed by Mr. Trump?
​

That one's easy. The so called "Affordable Healthcare Act" never was affordable. The rates have gone up every year since the ponzi scheme was signed into law.

 

[Harshaw]

they do that with auto insurance, but apparently you don't have a problem with that.

There is no tax penalty for not carrying auto insurance. I don't have a problem with it because it doesn't happen.

You're not required to carry auto insurance as a condition of living. You're only required to carry it if you operate a motor vehicle on public roads, for the sole purpose of damage you might do to other people, and if you don't and get caught, you simply lose your driver's license, usually not permanently.

You ARE required to carry health insurance on yourself if you're an adult human, for which there was, until recently, a tax penalty if you didn't.

It's not the same. Pretending it is is exceedingly disingenuous.

 

[Media_Truth]

The premium increases under Obama were lower than those under Bush.



The law is a godsend for the people it was intended to help, people like me. It ended preexisting conditions and brought affordable health care to some 18 million people who did not have it before the ACA.

But, republicans have sabotaged it, so any bad stats therefrom cannot be held against it, nor can the examples in states that did not allow it in their states, medicaid expansion, etc.

In states that embraced it, like California, it works very well. It needs tweeking, as all large bills do when they are introduced, but the republicans will have none of that, they don't want Obama to succeed.

What was a disaster was the state of things before the ACA, where insurers hired teams of claims adjusters whose sole purpose was to figure out ways to deny claims. You should have seen the 60 minutes segment on this, it was revealing.

Absolutely - the situation before the ACA was spiralling out of control in a major way. Premiums were going UP-UP-UP. The uninsured were still getting treated, by going to the Emergency Room. And who was paying for that? We all were - it's called subsidized emergency room care. Insurance CEOs and Executives were the only ones that were making out like bandits.

 

[TU Curmudgeon]

No mystery to me at all.

None of them have 50 - sort of independent - states with their own funding (to a certain degree) , 50 governors and 100 senators who can "make" serious laws that apply to their state only ... like for instance death penalty ... or lighter ones, like speed limit.

Canada has 10 - sort of independent - provinces with their own funding (to a certain degree), 10 Premiers, and 104 Senators. Admittedly, Canada has only one Criminal Code but the several provinces do set their own speed limits - even on "federal" highways.

There is no other nation in this world that is comparable to the US of A.

Would you like to look up the meaning of the word "comparable"?

You do know that it does not mean the same thing as "identical", don't you?

 

[TU Curmudgeon]

There is no tax penalty for not carrying auto insurance. I don't have a problem with it because it doesn't happen.

You're not required to carry auto insurance as a condition of living. You're only required to carry it if you operate a motor vehicle on public roads, for the sole purpose of damage you might do to other people, and if you don't and get caught, you simply lose your driver's license, usually not permanently.

You ARE required to carry health insurance on yourself if you're an adult human, for which there was, until recently, a tax penalty if you didn't.

It's not the same. Pretending it is is exceedingly disingenuous.

The comparison between "driving" and "living" is always amusing.

Since when did "living" become as optional as "driving" is?

 

[Harshaw]

The comparison between "driving" and "living" is always amusing.

Since when did "living" become as optional as "driving" is?[/QUOTE]

Precisely why the comparison between the health insurance mandate and auto insurance is entirely specious. Though I hardly think that was your point.

 

[Barnacle]

Canada has 10 - sort of independent - provinces with their own funding (to a certain degree), 10 Premiers, and 104 Senators. Admittedly, Canada has only one Criminal Code but the several provinces do set their own speed limits - even on "federal" highways.
Would you like to look up the meaning of the word "comparable"?

You do know that it does not mean the same thing as "identical", don't you?

Don't make me laugh ... :lamo

Your senators are appointed for life by ... "... in theory by the Governor-General, but in practice by the Prime Minister, ...".

They have no power whatsoever ... (grin) ... "... Mostly, the Canadian Senate has become just a rubber stamp for decisions made by the lower house, akin to the House of Lords in the U.K. ..."

 

[TU Curmudgeon]

Since when did "living" become as optional as "driving" is?

Precisely why the comparison between the health insurance mandate and auto insurance is entirely specious. Though I hardly think that was your point.[/QUOTE]

Since that was EXACTLY my point, I won't take issue with your "I hardly think".

 

[Harshaw]

Precisely why the comparison between the health insurance mandate and auto insurance is entirely specious. Though I hardly think that was your point.

Since that was EXACTLY my point, I won't take issue with your "I hardly think".

My bad.

 

[TU Curmudgeon]

Don't make me laugh ... :lamo

Your senators are appointed for life by ... "... in theory by the Governor-General, but in practice by the Prime Minister, ...".

They have no power whatsoever ... (grin) ... "... Mostly, the Canadian Senate has become just a rubber stamp for decisions made by the lower house, akin to the House of Lords in the U.K. ..."

Not having to run for re-election means that you aren't likely to get tossed out of office merely because you get the odd "perk" tossed your way.

Actually the Senate DOES have a lot of power. In fact the Canadian Senate has almost as much power as the US Senate has, it just doesn't use it.

 

[TU Curmudgeon]

My bad.

Happens

<[8-P

 

[eohrnberger]

wait i thought the ACA was supposed to end this and costs were supposed to go down not up?
the ACA was a failure from the start and obama owns this failure not trump but then again facts don't
seem to matter to you.

TDS failure.

ObamaCare's only objective was to destroy private health care, so the government could take over and institute a single payer, government run health care system, which would perform on par with the VA, also a a single payer, government run health care system, and previous performance being a good indicator of future performance . . . .

If you notice, now, one of the frequent Dem talking points, is in fact a single payer, government run health care system.

 

[smallvoice]

If you want to do something incredibly unusual on the Internet, and that is to step back from preconceptions and look at the situation dispassionately, the real "problem" with the ACA is that it was akin to trying to cross a swamp in three steps without getting either foot muddy.

Yet Barry waded right in, dragging the rest of us with him....

 

[dcsports]

I never said it would solve all problems, just the specific problem I addressed in that post - the pre-existing condition problem.

OK -- fair enough. It would solve one specific issue. The problem is that it would create others.

We didn't rip out the system. Don't talk nonsense. The big changes were to private, non-employer plans, which is about 10% or so of the total insured.

Yes, private insurance plans. We ripped out that part of the system, and replaced it with a more expensive system, leaving many worse off than they were before..

OK, when/where have state sponsored risk pools worked? I am pretty sure the answer is never and nowhere, but I'm willing to listen. The problem is obvious - if you give insurers a dumping ground for those with pre-existing conditions funded by taxpayers, they'll find a way to dump them, because that's how they make the most money.

Many states used them prior to Obamacare, and yes, they worked. Not without issues - the premiums were more than standard private insurance. They were by no means a perfect solution, but it allowed many to obtain coverage that otherwise couldn't. We could have expanded this and added federal subsidies.

Not sure what you mean by dumping grounds. If someone was denied for a pre-existing condition, they didn't have coverage. And again, the point was there were other options to explore.

 

[dcsports]

Be specific - how did changes to the employer based market "gut" that part of our system? What changes do you consider a "gutting" of employer based insurance pre-ACA? "Impacted" is one thing - of course they were "impacted"- but that's not what you're arguing.

I think you are confusing the types of insurance, which is what I tried to explain. Employer based insurance is group insurance. (Some professional associations also provide group insurance.) That's different than a private insurance plan. Again, group insurance was impacted, not gutted.

Again, we can argue whether this was a "gutting" of that market or not, but it's roughly 10% of those with insurance. You've not addressed the 90% who didn't get insurance in the private market. Did ACA "gut" Medicare? Medicaid (which was expanded)? VA?

And no matter what you think, there's no credible argument that the non-employer market was anything but broken pre-ACA, and with the ACA subsidies the number insured in this market grew, not shrank, and millions of people uninsurable pre-ACA because of pre-existing conditions are now insurable and insured so I'm not sure how that's a devastation of the private market.

It's absolutely true that the impact on some significant share of the non-poor who bought off the private market were at least arguably made worse off because of the increase in premiums, but then you should limit your critique to the impacts on that group and not generalize this share of 10% of the population as a "gutting" of health insurance in the U.S.

I didn't say group insurance was gutted. Didn't say Medicare was gutted (although, it was stripped of a lot of funding). Didn't say medicaid or the VA was gutted. I wasn't trying to address those.

I said private insurance -- insurance that individuals purchase from a commercial insurance company. And while it may impact "only" 10% - that's still a lot of people. The ACA gutted this market -- eliminating plans that millions were satisfied with, replacing them with more expensive plans, often with overages they didn't need or want, stripping them of their physicians and other healthcare providers. And many (most) of those new plans later dropped out of the market, causing further changes.

Yes, a number of people who previously could not get insurance now could, and that's a good thing. But at what cost? Why not find ways to help this group without devastating private insurance plans, stripping funding from other programs, and impacting group plans, that were working fine? You actually highlight a great point with the medicaid expansion - almost all of the increase in people with coverage came from this effort, which didn't impact those other sectors.