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Uninsured Rate

Thanks Donald: Trump Sabotage Leads To Highest Uninsured Rate Since 2014

Gallup’s quarterly health survey reveals that the uninsured rate has risen to the highest rate since the Affordable Care Act’s coverage expansion was completed. A major reason for this increase? Trump’s relentless health care sabotage. Take a look for yourself:

Gallup’s Own Release Cites Trump Administration Sabotage In Its Explanation Of The Rising Uninsured Rate: “The Open Enrollment Periods Since 2018 Have Been Characterized By A Significant Reduction In Public Marketing And Shortened Enrollment Periods Of Under Seven Weeks, About Half Of Previous Periods.” Among the factors Gallup cites as playing a role in the increase of the uninsured rate:

  • Increasing Premiums: “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 (although most states saw premiums stabilize for 2019).”  [Gallup, 1/23/19]
  • Major Cuts To Open Enrollment: “The open enrollment periods since 2018 have been characterized by a significant reduction in public marketing and shortened enrollment periods of under seven weeks, about half of previous periods.” [Gallup, 1/23/19]
  • Slashed Funding For Navigator groups: “Funding for ACA ‘navigators’ who assist consumers in ACA enrollment has also been reduced in 2018 to $10 million, compared with $63 million in 2016. Overall, after open enrollment in the ACA federal insurance marketplace (i.e., healthcare.gov) peaked in 2016 at 9.6 million consumers, it declined by approximately 12.5%, to 8.4 million in 2019, based on recently released figures.”  [Gallup, 1/23/19]
  • Trump’s Hostility To The ACA: “Other potential factors include political forces that may have increased uncertainty surrounding the ACA marketplace. Early in his presidency, for example, President Donald Trump announced, ‘I want people to know Obamacare is dead; it’s a dead healthcare plan.’ Congressional Republicans made numerous high-profile attempts in 2017 to repeal and replace the plan. Although none fully succeeded legislatively, the elimination of the ACA’s individual mandate penalty as part of the December 2017 Republican tax reform law may have reduced participation in the insurance marketplace in the most recent open enrollment period. Trump’s decision in October 2017 to end cost-sharing reduction could also potentially have affected the uninsured rate.” [Gallup, 1/23/19]

Los Angeles Times: Uninsured Rate Under Trump Surges To Highest Level Since Obamacare Began. “The percentage of American adults without health insurance surged upward in 2018, reaching levels not recorded since before President Trump took office, according to a new national survey that revealed widespread coverage losses over the last two years…The new number represents the highest uninsured rate since the beginning of 2014, when the Affordable Care Act began providing billions of dollars in aid to help low- and middle-income Americans get covered, according to the survey by Gallup. The new report also indicates that some 7 million American adults have likely lost or dropped coverage since 2016…Since taking office, however, Trump has repeatedly attacked the healthcare law and enthusiastically backed a 2017 effort by congressional Republicans to roll it back.” [Los Angeles Times, 1/23/19]

HuffPost: The Uninsured Rate Is The Highest It’s Been In Five Years. “About 7 million fewer Americans had health insurance at the end of last year compared with two years prior, and the share of people who are uninsured is the highest it’s been since 2014, according to a new survey…Since his first day in office, Trump has directed and overseen policies that undermine the health insurance exchanges. The administration has dramatically reduced funding for advertising, marketing and outreach to draw eligible customers to the exchanges during open enrollment and for programs that help consumers navigate the sign-up process. The Republican tax package Trump enacted in 2017 repealed the Affordable Care Act’s fines on people who didn’t obtain health coverage under the law’s individual mandate, freeing people to go uninsured without penalty and causing insurers to increase prices on the assumption that healthier people are less likely to buy coverage in the absence of fines. Perhaps most consequentially, Trump ended payments to health insurance companies serving the lowest-income customers, which led insurers to increase prices to make up for the lost revenue.” [HuffPost, 1/23/19]

Vox: Under Trump, The Number Of Uninsured Americans Has Gone Up By 7 Million.Certain demographic groups are experiencing a greater loss of coverage than others. Gallup data shows, for example, that Americans who are younger and lower-income have seen a greater decline in insurance coverage than those who are older and wealthier. Women have had insurance rates decline more quickly than men. This trend is especially surprising given that over the same time period, the unemployment rate has been declining. Usually, when more people have jobs, it means more people with access to employer-sponsored health insurance. But even during this period of job growth, America’s uninsured rate keeps climbing.” [Vox, 1/23/19]

Forbes: Uninsured Rate Hits Four-Year High Amid Trump’s Obamacare Attacks. “The rate of Americans without health insurance has ‘risen steadily’ to 13.7% from 10.9% in 2016 , data released Wednesday as part of Gallup’s national “health and well-being index,” which drew from a quarterly data sample of about 28,000 adults…Following his 2016 election, Donald Trump swept into the White House in January of 2017, promising to repeal and replace the ACA, also known as Obamacare. That effort was a failure because the Republican-led Congress of 2017 was unable to repeal the law nor did GOP lawmakers come up with a replacement plan. But the Trump White House has made several policy moves that the Gallup analysis indicates has contributed to fewer people having coverage. ‘The open enrollment periods since 2018 have been characterized by a significant reduction in public marketing and shortened enrollment periods of under seven weeks, about half of previous periods,’ Gallup’s analysis said.” [Forbes, 1/23/19]

CNBC: Rate Of Americans Without Insurance Rises To 4-year High As Trump Weakens Obama Health Law, Gallup Survey Finds. “The percentage of U.S. adults without health insurance reached a four-year high in the last quarter of 2018, but was still well below the peak level seen before Medicaid expansion under the Affordable Care Act in 2014, a new Gallup survey published Wednesday found. The national uninsured rate climbed to 13.7 percent in the fourth quarter of 2018, its highest level since the first quarter of 2014 when the rate reached 13.4 percent, according to data the compiled from Gallup. Women and adults under the age of 35 reported among the highest rates without insurance at 12.8 percent and 21.6 percent, respectively, the survey found.” [CNBC, 1/23/19]

Axios: “Gallup’s Quarterly Health Surveys Tell A Pretty Clear Story, Which It Attributes To The Trump Administration’s Handling Of The ACA.” “The number of Americans without health insurance has been creeping higher throughout the Trump administration, and it’s now the highest it’s been since the Affordable Care Act’s coverage expansion took effect in 2014, according to Gallup’s latest survey…Women, lower-income households and young people saw the biggest coverage losses, according to Gallup…Gallup’s quarterly health surveys tell a pretty clear story, which it attributes to the Trump administration’s handling of the ACA.” [Axios, 1/23/19]

Protect Our Care Statement On Gallup Poll Showing The Uninsured Rate Jumping To The Highest Level In 5 Years

YEARS OF REPUBLICAN SABOTAGE RESULTS IN THE FEWEST PEOPLE COVERED SINCE THE PASSAGE OF THE ACA, HURTING WOMEN, LOWER-INCOME HOUSEHOLDS, AND YOUNG PEOPLE THE MOST

Washington DC — Today, according to a new Gallup Health and Wellbeing-Index, about 7 million fewer people had health care in 2018 compared to the previous year. The uninsured rate has steadily increased during the Trump administration from a low of 11 percent in 2016, the lowest since the passage of the Affordable Care Act (ACA). The rate was 14 percent in the last quarter of 2018. Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“Years of Trump administration and Republican sabotage of the ACA continues to take its toll. The Trump administration regularly claims it’s making health care better, but the proof is in the pudding — he’s sabotaging the system and ripping coverage away from millions of families.  And Trump’s sabotage hits women, lower income households, and young people especially hard.

“President Trump and his allies in Congress must stop their partisan war on health care before they rip coverage away from millions more. Our focus should be on lowering costs and helping more people get coverage, but Republicans insist on taking us backwards – the exact approach voters rejected in November.  It’s past time for Congress to step in and put the brakes on Trump’s health care sabotage because millions of Americans are paying the price with less coverage and higher costs.”

In Case You Missed It: Under Trump, Uninsured Rate Increases For First Time Since Implementation Of Affordable Care Act

Last Friday, analysis by the Kaiser Family Foundation illuminated the impact of the Trump Administration’s non-stop sabotage on Americans’ health care: the number of uninsured nonelderly adults increased by nearly 700,000 in 2017.

After repeatedly attempting and failing to repeal the Affordable Care Act, President Trump and congressional Republicans pursued a relentless effort to sabotage the law. Kaiser’s analysis of the uninsured rate shows that Republicans’ sabotage agenda has jeopardized Americans’ access to care, particularly in states that refused to expand Medicaid. Take a look at Kaiser’s key findings below:

In 2017, The Uninsured Rate Increased For The First Time Since 2010. “As early provisions of the ACA went into effect in 2010, and as the economy improved, the number of uninsured people and uninsured rate began to drop. When the major ACA coverage provisions went into effect in 2014, the number of uninsured and uninsured rate dropped dramatically and continued to fall through 2016, when just below 27 million people (10% of the nonelderly population) lacked coverage…In 2017, the uninsured rate reversed course and, for the first time since the passage of the ACA, rose significantly to 10.2%.”

More People Became Uninsured In States That Refused To Expand Medicaid. “Changes in the uninsured rate in the set of states that expanded Medicaid were essentially flat overall…In contrast, the uninsured rate in states that did not expand Medicaid increased both overall (rising by 0.6 percentage points) and for most groups.”

More Proof: Trump Administration Targets Latinos In Its Open Enrollment Sabotage

Washington, DC – As part of its efforts to sabotage open enrollment, the Centers for Medicare and Medicaid Services removed a training guide for Latino outreach from a CMS website. This move is just one more part of the Administration’s sabotage efforts, including drastic cuts to outreach efforts and shortening the enrollment time period. Leslie Dach, Chair of Protect Our Care, issued the following statement in response:  

“From day one, Donald Trump has worked to sabotage health care for millions of Americans. Now, the Administration has targeted Latinos by deleting critical information from the HHS website that provides training for navigators as they assist Latino communities during the enrollment period. We all know open enrollment is a critical time for Americans to get the coverage they need. The Affordable Care Act is particularly important to Latinos, who are uninsured at a disproportionately high rate of 22 percent. There is no doubt in my mind that the Trump Administration is taking active steps to harm health care at the expense of the American people.”

 

BACKGROUND:

22 Percent Of Hispanic Americans Are Uninsured. The uninsured rate of Hispanic Americans is 22 percent, more than twice that of white Americans, 9 percent of whom are uninsured.

Between 2016 And 2018, The Trump Administration Has Cut Funding For Groups That Help People Sign Up For Coverage By 84 Percent. After cutting funding for navigator groups that help people sign up for coverage from $63 million in 2016 to $36 million in 2017, the Trump administration made yet another round of cuts in 2018, leaving just $10 million in funding for health navigator groups. Since 2016, Trump has cut navigator funding by 84 percent.

Health Navigators, Like Jodi Ray At The University Of South Florida, Say Cuts To Navigator Programs Prevent Them From Adequately Letting People Know That Open Enrollment Is Happening. Ray said, “We don’t have the people to provide the enrollment assistance nor to do the outreach and marketing to let people know what’s happening.”

This Year, 800 Counties Served By The Federal Marketplace Are Operating Without Any Federally Funded Navigators. This is more than six times as many counties served by the federal marketplace that operated without federally funded navigators in 2016, when 127 counties lacked such a navigator.  

The Trump Administration Wants Navigator Groups To Push Consumers To Sign Up For Junk Coverage That Is Exempt From Covering Prescription Drugs And Hospitalization Instead Of Comprehensive Plans. The Administration announced in July that it would encourage navigator groups to use their remaining funding to push consumers to sign up for junk health plans, which cover few benefits and notorious for the fraud they attract.

In 2017, The Trump Administration Cut The Open Enrollment Advertising budget By 90 Percent. As ABC News summarized, “In 2016, the Centers for Medicare & Medicaid Services spent $100 million on Obamacare advertising and outreach, but for [2017]’s open enrollment period, CMS plans on spending $10 million.” CMS chose not to increase the budget for 2019.

 

A full timeline of the Trump administration’s crusade to sabotage open enrollment is below:

October 2018

  • The Trump administration issues guidance that allows federal subsidies to be used to purchase junk plans that can deny coverage to people with pre-existing conditions, a move expected to worsen ACA risk pools.
  • Trump administration announces scheduled maintenance on the open enrollment website, preventing people from signing up for coverage on Sundays from 12:00 AM – 12:00 PM.

August 2018

  • Trump administration finalizes rule for bare-bones short-term plans that are exempt from key consumer protections, such as the requirement that insurance covers prescription drugs, maternity care, and hospitalization.

July 2018

  • Trump Administration slashes funding for non-profit health navigator groups that help people shop for coverage, from $36 million to $10 million. CMS encourages groups to use the remaining funds to push people to sign up for junk plans that skirt important consumer protections.

July 2018

  • Trump Administration limits access to assistance for consumers who want to enroll in marketplace coverage. This change removes the requirement that every area has at least two “navigator” groups to provide consumer assistance and that one be local. Now, just one group could cover entire states or groups of states.

December 2017

  • Congressional Republicans pass their tax scam, which doubles as a sneaky repeal of the Affordable Care Act by kicking 13 million people off of their insurance and raising premiums by double digits for millions more.

October 2017

  • The Trump Administration dramatically cuts in-person assistance to help people sign up for 2018 health coverage.

September 2017

  • The Administration orders the Department of Health and Human Services’ regional directors to stop participating in Open Enrollment events. Mississippi Health Advocacy Program Executive Director Roy Mitchell says, “I didn’t call it sabotage…But that’s what it is.”

August 2017

  • The Administration cuts the outreach advertising budget for Open Enrollment by 90 percent, from $100 million to just $10 million – which resulted in as many as 1.1 million fewer people getting covered.

July 2017

  • The Trump Administration uses funding intended to support health insurance enrollment to launch a multimedia propaganda campaign against the Affordable Care Act.

April 2017

  • The Trump Administration cuts the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days.

January 2017

  • Also on January 20th, the Department of Health and Human Services begins to remove information on how to sign up for the Affordable Care Act.
  • The Trump Administration pulls funding for outreach and advertising for the final days of 2017 enrollment. This move is estimated to have reduced enrollment by nearly 500,000

Trump, GOP War on Health Care Throws Children Under the Bus Study Finds

Washington DC — For the first time in a decade, the number of uninsured children nationwide has increased, up to 5 percent from 4.7 percent in 2016, according to a recent report released by Georgetown University Center for Children and Families. This historic reversal of progress comes on the heels of the Trump Administration’s continued sabotage of health care, plus Republican state officials’ stubborn refusal to expand Medicaid, despite widespread support. In response to the study, Brad Woodhouse, executive director of Protect Our Care, said:

“President Trump has led a Republican war on health care that has claimed many victims, but most shocking and appalling of all is its impact on our nation’s most vulnerable Americans: our children. After decades of progress, last year more than a quarter million more children were uninsured than in 2016 due to President Trump and the GOP’s repeal and sabotage agenda.  This is an outrageous display of the Trump Administration’s total disregard for Americans’ health care. Whether by voting to expand Medicaid or by voting to replace pro-repeal Republicans with health care champions, the American people have made it crystal clear that they don’t want to give up an inch of progress on health care anymore and they are demanding an end to the Republican war on health care.”

 

Key Reasons for the decline in children’s coverage:

Divergent State Policies Have Led To Vastly Different Changes In The Children’s Uninsured Rate Across States — For Instance, The Uninsured Rate For Children Increased At Triple The Rate In States That Did Not Expand Medicaid As It Did In States That Expanded Medicaid. “In previous years, states have moved in similar but not uniform directions, reflecting the many ways state policy decisions can impact eligibility and enrollment in Medicaid and the Children’s Health Insurance Program (CHIP). The absence of significant progress across the country suggests that even states with the best intentions were unable to withstand strong national currents to protect children from losing health coverage…Three-quarters of the children who lost coverage between 2016 and 2017 live in states that have not expanded Medicaid coverage to parents and other low-income adults. The uninsured rates for children increased at almost triple the rate in non-expansion states than in states that have expanded Medicaid.”

Trump And His Republican Allies Have Repeatedly Tried To Repeal And Sabotage The Affordable Care Act And Have Slashed Funding For Outreach. “These national currents include a lengthy and ultimately unsuccessful congressional effort to repeal the Affordable Care Act (ACA) and cap federal Medicaid funding, as well as an unprecedented delay by Congress that allowed CHIP funding to lapse temporarily. In addition, Congress repealed the ACA’s individual mandate and the Trump Administration made numerous efforts to undermine the ACA Marketplaces, including dramatically cutting outreach and enrollment grants and shortening the open enrollment period.

Trump’s Punitive Immigration Policy Deter Children From Enrolling In Medicaid And CHIP. “Finally, one-quarter of all children under 18 living in the United States have a parent who is an immigrant. Several policies targeting immigrant communities are likely deterring parents from enrolling their eligible children in Medicaid or CHIP despite the fact that most of these children are U.S. citizens.

“All of these changes in the national political and policy realm mark a sharp reversal after many years of successful efforts to reduce the uninsured rate for children and families.”

CBO Confirms: GOP Sabotage Is Raising Costs, Reducing Coverage

Yesterday, the nonpartisan Congressional Budget Office released a report detailing the higher costs Americans are facing due to the GOP’s repeal and sabotage campaign. Among its conclusions: premiums will be going up double-digits, 5 million more Americans than originally anticipated will lose health insurance, and these negative consequences are happening because of Republicans’ actions. Here are the key takeaways:

Washington Post: “The Reality Is Republicans Leading Both Chambers And The White House Have Acted In Ways That Could Trigger The Rise Of Premiums.” “The reality is Republicans leading both chambers of Congress and the White House have acted in ways that could trigger the rise of premiums. They’ve repealed the law’s individual mandate, paving the way for healthier people to leave the marketplaces and leave sicker, more expensive patients behind. They’re working to expand leaner plans exempt from ACA coverage requirements. And they haven’t found a way to pay extra subsidies in order to defray extra plan costs for the lowest-income customers.” [Washington Post, 5/24]

CNN: Individual Mandate Repeal “Alone Will Cause Premiums To Be 10% Higher.” “Congress eliminated the penalty associated with Obamacare’s individual mandate as part of its tax reform package last year. This change alone will cause premiums to be 10% higher because fewer healthy people will buy coverage, leaving insurers with a sicker and costlier group of policyholders, the CBO projected.” [CNN, 5/23]

CNBC: “The CBO Also Projects About 5 MIllion More People” Will Be Uninsured, “Up To A Total Of 35 Million People.” “The CBO also projects about 5 million more people under the age of 65 will be uninsured in 2027 than it estimated in September, up to a total of 35 million people… Trump and congressional Republicans tried unsuccessfully to repeal the landmark health law multiple times last year. They managed to repeal the individual mandate, which required most people to have some form of health insurance or pay a tax penalty, as part of the broader tax law it passed in December. The change is slated to go into effect next year. This coupled with higher premiums will cause 3 million more people than previously forecast to be uninsured next year, CBO estimates. Between 2019 and 2028, it expects the number of uninsured people to increase to 35 million.” [CNBC, 5/23]

The Hill: “ObamaCare Premiums Are Expected To Rise An Average Of 15 Percent Next Year, An Increase Largely Due To The GOP’s Repeal Of The Individual Mandate.” “ObamaCare premiums are expected to rise an average of 15 percent next year, an increase largely due to the GOP’s repeal of the law’s individual mandate, according to a Congressional Budget Office (CBO) analysis released Wednesday. The CBO estimates that gutting the requirement that Americans have health insurance or face a tax penalty will contribute to about a 10 percent rise in premiums for 2019, with insurers expected to see healthier people dropping out of the marketplaces, leaving sicker enrollees on the plans.” [The Hill, 5/23]

Bloomberg: “One Reason For The Rising Premiums Is The Actions Of President Donald Trump.” “One reason for the rising premiums is the actions of President Donald Trump. Last year, Trump topped funding for the cost-sharing reduction payments made to insurers under Obamacare to help Americans afford health costs. The non-payment of those subsidies, less enforcement of a rule requiring people to have insurance and limited competition caused insurers to raise their premiums by about 34 percent in 2018, compared to 2017. That increased the cost of the subsidies to the federal government, according to the CBO.” [Bloomberg, 5/23]

Axios: “The Magnitude Of These Increases Stems Largely” From Administrative Actions. “Insurance premiums tend to go up every year, but the magnitude of these increases stems largely from the repeal of the ACA’s individual mandate, the expansion of skimpy short-term plans, and the decision last year to cut off the law’s cost-sharing payments. [Axios, 5/24]

Justine Handelman, Blue Cross Blue Shield Association Vice President: “It Continues To Be Uncertain Times.” “Although the administration hasn’t teed up any new policy announcements lately, senior officials from the Blue Cross Blue Shield Association told reporters yesterday that there’s still reason to be nervous.  It’s too late to help moderate premium hikes for 2019, they said, so they’re focused on 2020. They’re hoping new policies like the change in short-term plans won’t take effect until 2020, so that they won’t upend the market assumptions plans have made for next year.‘It continues to be uncertain times,’ said Justine Handelman, a BCBSA senior vice president.” [Axios, 5/24]

Kris Haltmeyer, Blue Cross Blue Shield Association Vice President: “‘With the repeal of the individual mandate and the failure of Congress to enact stabilization legislation, we are expecting premiums to go up substantially,’ Haltmeyer said… Haltmeyer said the premium increases are ‘related to the loss of the mandate and then underlying medical costs.’ ‘Those two things have the most impact on the rate increases,’ he added.” [The Hill, 5/23]

Seema Verma Admits Her Administration Will Let Uninsured Rate Continue to Rise

Washington, D.C. – This morning at the America’s Health Care Future event hosted by the Washington Post, Centers for Medicare & Medicaid Services Administrator Seema Verma admitted that the uninsured rate will continue to rise under their watch. Protect Our Care Campaign Director Brad Woodhouse released the following statement in response:

“Administrator Verma’s remarks this morning are only the latest example of the Trump Administration demonstrating their total disregard for Americans’ health care. During President Trump’s first year in office, the uninsured rate grew by 3 million – the largest increase since 2008. During President Trump’s second year in office, premiums are expected to increase double-digits across the country. The Trump Administration and Republicans in Congress have carried out a sabotage campaign designed to make  the Affordable Care Act fail, and they have succeeded to the detriment of the American people. Administrator Verma’s admitting that the Administration has no plans to stop this suffering is disgraceful. Enough is enough – it’s time for the GOP to end their war on health care.

Gallup Poll: Uninsured Rate Rose in Trump’s First Year

After a new Gallup poll showed that America’s uninsured rate jumped during Trump’s first year in office for the first time in a decade, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“This is what sabotage looks like. Today, Gallup confirmed that over 3 million Americans lost their insurance in 2017, becoming the first casualties of President Trump and Congressional Republicans’ war on health care. Today’s numbers also confirm that it’s exactly those Americans who the Trump administration targeted who are losing coverage: working families earning less than $36,000 a year, young adults, African-Americans, and Hispanics. On behalf of the 3 million who have already lost their coverage, and will now pay the price with their health — and the millions more whose insurance is under attack, we join the American people in saying: enough is enough. President Trump and his allies in Congress must stop their partisan war on health care before they take coverage from millions more and and drive up prices and weaken protections for everyone else.”