Uninsured in the US hits 13.7%

 

Despite the rise in the uninsured rate, it's still below the peak of 18%, recorded in the third quarter of 2013. That figure then dropped to an all-time low of 10.9% in 2016. The elimination of the individual mandate penalty, cost-sharing reductions and other policy decisions made under the Trump administration has helped boost the rate again.

ACA helped reduce uninsured rate

The Affordable Care Act helped the US reach historical lows for the rate of uninsured adults, but that figure has continued to tick back up as the Trump administration has undermined the law. The continued rise in the uninsured rate is reversing the gains made under the Affordable Care Act.

The ACA ushered in a time when people could buy insurance not tied to a job — without having to worry about being denied for having a pre-existing condition such as diabetes or cancer. Plus, it allowed states to expand Medicaid to low-income residents who otherwise could not afford to purchase private coverage on their own.

During that time of record-low uninsured rates, many Americans were required to have health insurance or risked incurring a financial penalty. But President Donald Trump has worked to overturn the law.

Impact of the Trump administration

In December 2017, the GOP's tax bill eliminated the financial penalty for not having insurance.

The uninsured tend to be 19 to 64 years old, male, have less than a high school education and/or have lower incomes. This profile is fairly different from the profile of the overall US population.

The uninsured rate has increased most among women, young adults and low-income Americans. Separate research has shown the number of uninsured children in the US has also increased for the first time in over a decade. 

A separate Commonwealth Fund report found that the uninsured rate was up significantly among working adults in states that did not expand Medicaid.

Myth of targeting the uninsured for medical travel

There is an old medical tourism myth that these uninsured Americans are targets for overseas healthcare. They are mostly too poor to afford this, a substantial number of them have no passport, and as not qualifying for free healthcare are likely to be healthy.

Research suggests that the uninsured include people between jobs, between insurances, illegal immigrants, criminals, tax avoiders, well off people who prefer to pay fines and pay for own healthcare, and those who refuse to join in with anything from the government such as car or income tax or compulsory insurance.

Years of national and state advertising have failed to make the uninsured market buy health insurance, so they will be equally immune to advertising for medical tourism.

But for people with a high deductible, seeking treatment for cover not insured such as dental care and cosmetic surgery, then they may still be a market, but nowhere near in the numbers claimed by some "medical tourism experts".

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