SALLY C. PIPES: The U.S. Census recently announced that the number of Americans without health insurance in 2011 fell for the first time in three years, to 48.6 million. That’s a decrease of 1.3 million from the 2010 figure.
Sounds like good news. But a closer look at the data suggests that this drop is illusory. Even worse, the report shows that two onerous provisions of ObamaCare — the expansion of Medicaid and the requirement that insurers cover children on their parents’ policies through age 26 — are making health insurance more expensive and harder to obtain.
Thanks to ObamaCare, the federal government can now essentially dictate to state governments whom they must enroll in Medicaid, the jointly financed federal-state health care program for low-income Americans. Accordingly, the Census data show that the number of Americans covered by Medicaid rose to 50.8 million — up from 48.5 million in 2010. About 16.5% of all Americans are now enrolled in the program.
So the number of Americans with insurance increased by 1.3 million — but the number of people with government-provided insurance through Medicaid jumped by 2.3 million. In other words, a whole lot of people dropped their private coverage and went on the public dole.
ObamaCare has expanded coverage by fiat — not by fixing our broken health care system.
The provisions that will most significantly expand Medicaid don’t even kick in until 2014. About half the 30 million uninsured Americans expected to get health insurance through ObamaCare are expected to be covered by Medicaid. The rest will receive subsidies that vary according to income from the federal government.
By 2016, one in four Americans will be enrolled in the program. And yet the Congressional Budget Office predicts that 23 million Americans will remain uninsured by 2019.
Even worse, those already covered by Medicaid aren’t getting the care they need.
Medicaid pays doctors substantially less than private insurance. So they often have no choice but to limit the number of Medicaid patients they’ll see. In many cases, reimbursements from the program fail to cover their costs — so they lose money.
According to a study published last year by the New England Journal of Medicine, two-thirds of children on Medicaid or the Children’s Health Insurance Program (CHIP), another government health care program for the poor, were refused appointments by doctors in the Chicago area. Just 11% of those with private insurance were turned away.
When Medicaid patients can get treatment, the care they receive will likely be substandard. In a 2010 study of nearly 900,000 major surgical operations published in the journal Annals of Surgery, Medicaid patients were twice as likely to die in the hospital after surgery than patients with private insurance. Patients with no insurance at all were 25% less likely to die than those with Medicaid.
The privately insured pay for ineffective Medicaid coverage twice — on their tax bills and then again in the form of higher premiums. Hospitals receive just 89 cents of every dollar that Medicaid beneficiaries cost. The privately insured make up the difference — by paying more for the same care.
ObamaCare also reduced the rate of insured by forcing insurers to cover children up to age 26 on their parents’ policies. According to the Commonwealth Fund, 2.5 million more adult children have coverage, thanks to this mandate.
But it’s also raised the cost of insurance by 1% to 3%. That’s equivalent to a premium hike for the average policy of $151 to $452 per year, according to a report by the congressional Joint Economic Committee (JEC).
As a result, private insurance is increasingly becoming unaffordable for those at the bottom of the economic ladder. Indeed, for every 1% increase in premiums, the number of uninsured rises by about 200,000 to 300,000 people, according to the JEC.
The bottom line is that fewer Americans are paying for their own insurance, while many more Americans are dependent on the government for insurance coverage.
The decrease in the number of uninsured seems like cause for celebration. But the new Census report belies the fact that ObamaCare is pricing ever more Americans out of the private insurance market — and consequently forcing them into substandard public coverage.
• Pipes is president, CEO and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is “The Pipes Plan: The Top Ten Ways to Dismantle and Replace ObamaCare” (Regnery 2012).