Ouch! It's a case of 2 steps forward and 3 steps back. 59.1 million people went without health insurance at some point in 2009 and the beginning of 2010.
That's nearly 60 million people who had their pre-existing condition clocks reset. ACA only protects children from pre-existing condition denials in 2010. (Adults get to wait until 2014 for that benefit.)
More troubling is that another 30 million people are on High Deductible Health Plans or Consumer Directed Health Plans (junk insurance on steroids).
What's more, the CommonWealth Fund published yet another study that shows 33% of people went without prescribed care due to costs. 20% had trouble paying medical bills and nearly half, 46% of insured people with low incomes skipped out on prescribed care.
We're losing ground on health care.
This is what happens when we confuse Health Insurance with Health Care.
Over 59 million people end up with neither insurance or care.
Over 100 million people (probably more) end up with health insurance they can't afford to use.
The CDC published their troubling early results along with their graphics last September:
From January through March 2010, 46.7 million persons of all ages (15.4%) were uninsured at the time of interview, 59.1 million (19.5%) had been uninsured for at least part of the year prior to interview, and 33.9 million (11.2%) had been uninsured for more than a year at the time of interview.
From January through March 2010, the percentage of children under age 18 years who were uninsured at the time of interview was 7.4%.
Private coverage decreased among near poor adults aged 18–64 years, from 52.6% in 1997 to 34.8% in the first 3 months of 2010, so that the uninsured rate (43.7%) is now higher than the private coverage rate
(34.8%) for this population
From January through March 2010, 59.9% of unemployed adults aged 18–64 years and 22.6% of employed adults in this age group had been uninsured for at least part of the past year. Also, 35.4% of unemployed adults aged 18–64 and 13.8% of employed adults in this age group had been uninsured for more than a year.
During the first 3 months of 2010, 26.6% of persons under age 65 years with private health insurance at the time of interview were enrolled in a high deductible health plan (HDHP), including 7.8% who were enrolled in a consumer-directed health plan (CDHP).
More than 50% of persons with a private plan obtained by means other than through employment were enrolled in a HDHP. An estimated 21.7% of persons with a private plan were in a family with a flexible spending
account (FSA) for medical expenses.
MSNBC reprinted this Reuter's story, but the math doesn't hold up when you compare CDC and Census Bureau figures. I'm sure there's some geeky, statistical explanation for this, but I don't have it for you.
The CDC reported 59.1 million, but I got 68.2 million when I compared the CDC percentages (26.2% of adults and 11.6% of children) to the the census data of a total population of 227+ million adults and 73+ million children living in the U.S. in 2008 2009 data would be higher population estimates and more than 68 million people, but it is also more difficult to link to for this diary and more work than I'm willing to do today.
Then again, I have to wonder, does it really matter if we have 59 million, 68 million or even 80 million people going without insurance at any point of any year if we aren't going to give a damn about it? Or, more importantly, enough of a damn to make sure everyone who needs care gets it? Right now, policy makers and most people are focused on getting everyone insurance. What good is insurance if you can't use it? What good is a policy if you don't have the money to cover the deductible, copay, coinsurance to go with it? What good is a prescription you don't have the money to fill it?
The NYT also published their take on these numbers and what they thought was most important.
"The data allow us to debunk two myths about health care coverage," said the C.D.C. director, Dr. Thomas R. Frieden. "The first myth is that only the poor are uninsured. Half of the uninsured are over the poverty level."
The second myth, he said, is that "it’s only healthy people who are uninsured — that young people are healthy and make a choice not to be insured." In fact, he said, two of every of five people without insurance during the previous year had at least one chronic condition, like diabetes, hypertension or asthma, and were far more likely than insured people to go without care they needed.
Affordability is a greater problem than ACA addressed. When you have insured people foregoing health care because they don't have the money for the cost sharing; then we haven't solved the core problem. When you have people above the poverty level going uninsured, it's going to take more than a mandate requiring these people to buy insurance to solve the problem.
Until then the Census Bureau and the CDC will continue to report the facts as they tabulate them. KFF and the Commonwealth fund will continue to report access issues. I wish I could end this diary on a happier note, but it seems to me that would be insensitive to the 59 or 68 million people who went uninsured during 2009-2010. At least new Hampshire is looking into a single payer solution.