The Uninsured Rate Didn't Go Up -- That's News
A case study in government programs that did what they were supposed to do
The federal government just put out a new report showing that the uninsured rate -- that is, the proportion of Americans without health insurance -- basically stayed flat in 2020, even though the pandemic caused unemployment to soar. It’s the same basic finding we saw earlier this month, when the Urban Institute published the results of its own survey on the uninsured.
Today at HuffPost, I wrote about these reports and what lessons we can take from them.
In one sense, the conclusions are surprising. The majority of working-age Americans get their health insurance through employment, which is why past economic downturns caused the uninsured rate to rise. But this time the Affordable Care Act was in place, offering expanded Medicaid and subsidized private insurance to people without coverage.
To be clear, the actual dynamics of who lost insurance, who gained it and why are complex, with wrinkles that researchers will have to spend months and maybe years analyzing. For example, lots of people lost work in 2020 but many of them were in low-wage jobs that didn't offer insurance anyway. I.e, they had no coverage to lose.
And the ACA alone can't explain what happened. COVID-19 relief measures played a big role too -- both by subsidizing businesses, so they could keep workers on payroll, and giving the unemployed extra money to keep their old benefits through COBRA.
But taken together, it sure looks like a combination of government programs did what they were supposed to do -- namely, protect people from hardship. And this news comes right as President Joe Biden and his allies are trying to enact major legislation designed to accomplish the same thing, only not just for health care.
The "human infrastructure" bill Biden and the Democrats want to pass this fall would create new programs and/or ramp up spending to support child care, paid medical leave, college tuition, home care for the elderly and people with disabilities ... and a few other things too.
Passing this legislation will require making the case that the legislation's inevitable trade offs are worthwhile. Among other things, more government means more government spending, which will require some combination of revenue, cuts or deficits.
Lots of people will find those options objectionable, for a variety of reasons that include the principled as well as the partisan.
But the new reports on the uninsured can be part of the conversation too, because they document the impact of government programs on people's lives. And that doesn't always get a lot of attention in American politics.
Here’s the link:
Thank you for reading.