Obamacare Slightly Increased Short-Term Uninsured

The best measurement of people who lack health insurance, the National Health Interview Survey published by the Centers for Disease Control and Prevention (CDC), has released early estimates of health insurance for all fifty states and the District of Columbia in 2015. There are two things to note.

First: About 70 percent of residents, age 18 to through 64, had “health insurance” in 2015, which is the same rate as persisted until 2006. Obamacare has not achieved a breakthrough in coverage. It has just restored us to where we were less than a decade ago.

What has also happened is a significant change from private coverage to government welfare (primarily Medicaid). The shift has been about five percentage points since 2006, and ten percentage points since 1997. (That is, there was no net change in coverage before the Great Recession, but there was crowding out of private coverage in favor of welfare.)

Categorizing people on welfare programs like Medicaid as having insurance is inaccurate, for the same reason categorizing people receiving cash welfare with employed people into one category of people “earning incomes” would be inaccurate.

Second: The National Health Interview Survey is the best survey because it asks people three questions: Whether they were uninsured at the time of the interview, whether they were uninsured for any time within a year, and whether they were uninsured for more than a year. Unfortunately, it does not differentiate between private coverage and welfare.

Between 2013 and 2015, the number of people who were uninsured for one year or more declined by 12.7 million, from 30.5 million to 17.8 million. However, the number uninsured for less than a year increased slightly from 16.9 million to 17.7 million.

I believe this reflects churning between private coverage, Medicaid, and Obamacare exchanges in the increasingly fragmented post-Obamacare landscape. People fall through the cracks, overwhelmed and confused by an unnecessarily complicated “market.”

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For the pivotal alternative to Obamacare, please see the Independent Institute’s widely acclaimed book: Priceless: Curing the Healthcare Crisis, by John C. Goodman.