In what might be the most predictable trend of the Trump era, the uninsured rate appears to be increasing. Because young people (along with African-Americans and Hispanics) saw the biggest declines in coverage, health care premiums will likely rise for most Americans faster than they otherwise would.
The trend is bad for those who no longer have insurance – and for those who do.
According to a Gallup survey, about 3 million fewer Americans had health insurance in 2017 compared with the previous year, when a higher percentage of Americans had insurance than at any point in our history. The Gallup-Sharecare Well-Being Index is clear, that 2017 saw the first reversal of coverage gains since the Affordable Care Act was fully implemented.
The uninsured rate consistently ticked down during the Obama era as the Affordable Care Act became more established. The law bent the cost curve, meaning even though health care got more expensive, as goods and services usually do, it increased at one of the slowest paces in the past half century. Not only that, private health insurers, who had mixed early results, began seeing profits. No matter. President Donald Trump and the Republican Party decided to undermine the law anyway. When they couldn’t manage to repeal it, they voted to gut it, reducing the federal government’s outreach efforts to the still-uninsured and finally removing the individual mandate.
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That’s why this new, disturbing trend could get worse. The Congressional Budget Office projects 13 million Americans will become uninsured because of the repeal of the individual mandate, which required that Americans buy health insurance or pay a small fine. Though it was unpopular, it was a linchpin of the law and a complement to the federal mandate that everyone receive care in emergencies, even when they couldn’t afford to pay. It made sure there were enough young, healthy people in the marketplace who don’t spend much on health care but whose presence kept premiums down for the older and sicker. For at least some middle-income Americans, those rising premiums will not be offset by the Trump tax cut.
The law helped stabilize hospitals, which didn’t have to write off as much debt from unpaid-for services. It also made it more likely that middle- and lower-income Americans would receive care and be less likely to face personal bankruptcies. More Americans with comprehensive coverage also helped push the abortion rate down to an all-time-low and lowered rates of teen pregnancy. It did all of this – along with helping millions of seniors pay for prescription drugs – while decreasing the deficit a tick. The new tax law will be responsible for fewer insured Americans and increasing the deficit once again.
It’s a horrific tradeoff. Health insurance provides peace of mind that a small bump in take home pay never could. Because Republicans aren’t committed to making sure this trend doesn’t take hold, it’s up to voters to find leaders who will be.