The U.S. Census Bureau last week released its latest count of the uninsured (along with a whole bunch of other stuff.) Almost all of the press reports were thrilled over the fact that the numbers of uninsured decreased for the first time since 2007.
The press attributed this mostly to ObamaCare’s new slacker mandate, allowing “children” to stay on their parent’s policies to age 26, even if they are living on their own, married, or even have kids of their own. (The grandchildren are not allowed to be on the grandparents’ policy — yet.)
So the number of people uninsured dropped from 49.9 million to 48.6 million, a decrease of 1.3 million. Kaiser Health News also attributed this improvement to higher enrollment in Medicaid, from 48.5 million to 50.8 million. Curious that the rise in Medicaid enrollment is identical to the 1.3 million decrease in the uninsured.
This suggests that perhaps the slacker mandate wasn’t all that important after all. In fact, the numbers on private insurance coverage, where all the newly enrolled young adults would be recorded, are very curious indeed. Get out your calculators, boys and girls, and look at the following excerpt from the Census Bureau numbers –
Private Health Insurance (in 000s)
|Column A||Column B||Column C|
Now, I am not a mathematician, but this is straight 7th grade arithmetic, so it should not be too hard to figure out. “Direct purchase” and “Employment based” are the only two categories listed under “Private Health Insurance,” so adding Column A and Column B should add up to the total in Column C, right? But it doesn’t. In fact, the “total” is 3,023,000 less than the two columns added for 2011. How can that be? There is a similar discrepancy in 2010.
Perhaps people are counted twice. Maybe they have both employer coverage and direct purchase (individual) coverage. But I have never experienced that, other than some supplemental dread disease or hospital indemnity coverage like AFLAC. Are these policies included in the Census count? How does Census define individual coverage? The footnotes of the table provide no clarification.
In any case, the gain in employer based coverage from 2010 to 2011 is only 730,000 people and that is offset by a drop in individual coverage of 103,000, for a net gain of 627,000, yet the gain in the “total” column is 1,176,000. How did that happen? How can the “total” gain be larger than the gain of the two categories of coverage? Where did the rest come from?
But there are other oddities here as well.
As you probably know, the problem of non-insurance is largely a Hispanic issue. No one ever points this out, maybe for fear of being called racist, but it is true. The rate of non-insurance in 2011 is 11.1% for whites, 19.5% for blacks, 16.8% for Asians, but a whopping 30.1% for Hispanics. That is why on a state-by-state basis the problem of the uninsured is concentrated in a few states like California, Texas, and Florida — all states with very large Hispanic populations. In fact, if you wanted to visualize a “typical” uninsured person it would be 24-year old Hispanic male working in a small grocery store.
Yet, the much-vaunted ObamaCare initiatives, whether we are talking the slacker mandate or the Medicaid growth, failed to help this population at all. Whites, blacks, and Asians all had fewer uninsured in 2011 than in 2010, but not Hispanics. For them the number of uninsured actually grew from 15,667,000 in 2010 to 15,776,000 in 2011.
But this whole obsession about the uninsured is misplaced. It is the most static issue one can imagine. For all of the past twenty-five years the percentage of insured Americans has been steady at about 85% and the percentage of uninsured has held at about 15%.
Now, there have been occasional wobbles in the ratio, and in 1999 the Census bureau changed the way it asked about Medicaid enrollment, so there was a technical correction then. But it is hard to imagine a steadier “trend.” It has remained the same during times of prosperity and times of recession, during times of high and low immigration, during times of high and low birth rates, during times of Republican and Democratic administrations, and in spite of dozens of new initiatives aimed at lowering “the problem of the uninsured.”
There is just one other observation worth making here. The Kaiser Health News story on this report interviewed a number of sources for its article. Included was someone from “the nonpartisan Economic Policy Institute,” someone else from “the non-partisan Urban Institute,” and a third person from “the conservative Heritage Foundation.” So the two liberal groups are identified as “nonpartisan” but Heritage is identified as strictly “conservative.” Don’t they ever get dizzy from the endless spinning?