This will be a multiple post article discussing the issues of uninsured Americans and some of the options available, but first lets look at the real uninsured numbers and the cause. Recently the big news has been that uninsured Americans increased in 2018 for the first time since Obamacare took effect in 2013 and of course everybody is blaming it on President Trump. This is true it did increase but lets look at the numbers in more details to see why and who really is uninsured. The actual increase was around 900,000 people and according to the CDC the count by education, income and job. The actual overall uninsured rate is around 9% of Americans so it’s important to note that when we talk about changes to insurance in America for the uninsured we are talking about less than 10%. This 10% of the population is important and needs coverage but some changes could also effect the 90% in a negative way, more on that later.
This chart by the CDC clearly shows two key factors that education and job play a direct role on rather you are insured. It is no secret that those with a high school diploma or less are more likely to be uninsured. The fact that the service industry has the highest rate of uninsured isn’t a surprise since these jobs are mostly filled by those with high school or less education. These Americans are also mostly like employed by smaller companies that face hardships when getting affordable insurance for their employees. Now lets get back to President Trump and the increase.
Decrease in unemployment
Unemployment under the Trump administration has decrease to record numbers and more people are returning to full time employment. To many this would be seem like a good thing for those without health insurance but that rule doesn’t apply to those making barely above the poverty level. As a result of their full time employment and increased income then they will no longer qualify for health insurance assistance. Increased employment is a good thing but can have it downside but lets not blame President Trump for this one.
Public Charge rule
President Trump did make a rule change called the Public Charge rule which makes it hard for immigrants to get their green card if they are on Medicaid. This is a good thing and this is why. If they are an immigrant on a work or student visa then they should be providing their own insurance. If they are here are a work visa then they should have employer based insurance and if your a student who can afford to go to school in the US then you should have the means to get your own insurance. Employers who hired from overseas should be required to provide these workers with insurance during and after their employment and the same for colleges. This leave the asylum seekers…. So in 2017 there are 27,000 new asylum seekers in the US, which is about 1/1000 of a percent of Americans so I don’t think they the real cause of the increase.
The Trump administration also removed the individual mandate which probably did more to increase the numbers more than anything else making it easier for those who can’t afford coverage to drop it. I am not in favor of the individual mandate but removing I am sure did increase the number but this is action of the individuals not those of President Trumps.
Changes in work type
One of the big surprises in this number was the large portion of working Americans who were uninsured. I don’t feel like this increase is due to changes in the government actions as it is to the changes in some work groups. Lets look at Uber for instance who doesn’t offer their drives . In 2015 there were approximately 325,000 Uber drivers in the US, in 2018 that number grew to around a million in 2018 for increase in around 675,000 drives but why does an increase in Uber drives matter to the uninsured numbers? The reason it matters is these jobs have moved from taxi companies which often do provide employee insurance to a company that doesn’t. If only 10 percent of the work done by Uber and Lfyt drives has previously been done by taxi companies than you are looking at roughly the equivalent of 100,000 people who now have no employee based health care. If true that only could account for 10% of the increase in uninsured Americans much more than the outrage over the Public Charge change. There is also an increase in Americans who are becoming self employed who do not have the option for a employer based insurance. I am now, nor have I ever, been a fan of forcing Americans pay for health insurance but I do believe employers have the responsibility to provide health care for their employees.
Overall yes President Trump can be blamed on some of the increase but how much is due to other factors in the job market in the US and or ever changing work environment.