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Morning Briefing

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Thursday, Sep 17 2015

Full Issue

Census: More People Have Health Coverage Even As Poverty Persists

The annual Census Bureau report, which provided 2014 numbers, is considered the gold standard for explaining how the nation is faring in terms of prosperity. The section on insurance coverage points to the effects of the Affordable Care Act, the new insurance marketplaces and expansion of Medicaid that year.

Nearly nine million people gained health insurance last year, lowering the ranks of the uninsured to 10.4 percent of the population. But there was no statistically significant change in income for the typical American household in 2014, the Obama administration said on Wednesday. ... Overall, the new census numbers suggest that one major government program, to provide health insurance under the Affordable Care Act, is working, but that for ordinary Americans, especially the poor, the economic recovery — now into its seventh year — has yet to deliver measurable benefits. (Pear, 9/16)

Thanks mostly to the first full-year impact of the Affordable Care Act, also known as Obamacare, the percentage of people without medical coverage fell to 10.4% from 13.3% the previous year. That represents a drop of 8.8 million, to 33 million people who were uninsured for part or all of last year. A decline was expected. Earlier surveys suggested a big increase in health plan enrollment as states expanded Medicaid and millions of Americans signed up for private insurance through new marketplaces created by Obamacare. Every state, racial group and age of individuals saw a decline in the uninsured rate, the Census Bureau said. (Lee, 9/16)

The census report, viewed as a key gauge of American prosperity, underscored how government policy—from expanded health-care coverage to benefits for the poor—has rippled through the lives of many Americans. Weak income growth was especially striking for a year in which employers added the most jobs since 1999 and stock markets hit new highs. The decline in those lacking coverage, driven largely by people receiving Medicaid or buying insurance on their own, was the largest in records that date to 1987. (Timiraos and Radnofsky, 9/16)

The data also show the extent to which tens of millions of people remain uninsured, at a time when the law’s opponents are debating its future once President Barack Obama leaves office. Critics can point out that the law is still set to fall well short of its early hopes to extend near-universal coverage. Some have already argued that its coverage gains haven’t justified its price tag (Radnofsky, 9/16)

The report, hailed by ACA supporters, is the first that compares the insurance landscape immediately before those changes began and afterwards. At the same time, the nation's official poverty rate stayed level at 14.8 percent, equivalent to 46.7 million people in poverty. A supplemental poverty measure, considered more accurate by many experts, showed the rate at 15.3 percent, similar to 2013. (Goldstein, Guo and Gamio, 9/16)

[A] change in the way health insurance questions are asked make this year’s report comparable to 2013 but not earlier years. Census officials, however, point out that a different annual survey that has asked health insurance questions consistently show this to be the biggest drop in the uninsured since at least 2008. Others say the sizable increase in Americans with insurance – due in large part to the implementation of the federal health law – is unprecedented since the creation of Medicare and Medicaid 50 years ago. (Rovner, 9/16)

The Census report did not delve into the quality of health insurance or the cost to consumers, which has continued to increase since the passage of Obamacare but at a slower pace. (Braverman, 9/16)

While other surveys and polls have recorded improvements in the uninsured rate since the ACA's rollout, the Census data is considered the benchmark for such measures. Still, a significant variation in coverage remains between U.S. states, with generally higher uninsured rates in states that declined to expand Medicaid coverage. Texas, Florida and Mississippi, which are among that group, have uninsured rates of more than 14 percent, among the highest in the country, Census said. The state with the lowest rate of uninsured residents is Massachusetts, at 3.9 percent. (Picchi, 9/16)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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