The percentage of Americans who are uninsured has jumped from 12.7 percent at the end of 2016 to 15.5 percent today in 17 states, including sharp cuts to outreach efforts.
Professor Swapna Reddy with ASU’s School for the Science of Health Care Delivery says it’s a disturbing and disappointing trend. A change in the uninsured rate will have effects on the market, costs and health care. She says it’s definitely not the direction the U.S. wants to be headed, and there are a few reasons that can explain the numbers. The main reason is likely confusion surrounding the Affordable Care Act.
“One hundred percent it’s still a law,” Reddy says. “Yes, people still have access to it. In 2017 President Trump and the Republican Congress went through many attempts to try to replace the Affordable Care Act and I think there’s a lot to be said about the confusion that whole process led to. While they were unsuccessful with a repeal and replace, most people couldn’t follow what was going on because so much was going on, and it led to a lack of confidence in whether or not the law was still in place.”
Reddy says that ironically, there are now more people who identify as Republican who are uninsured than Democrats, while the opposite was true in 2016. The sharp cuts to outreach efforts affects everyone who benefits from the Affordable Care Act. It hurts those who need it the most because they aren’t getting the information they need on how to enroll, Reddy says.
The climbing uninsured rate isn’t something that should be ignored. As Reddy says, those who don’t have health care don’t just vanish. They still have to be taken care of.
“I don’t know where they’re going to get health care,” Reddy says. “They don’t just disappear. A lot of times they are getting sicker because they don’t have the preventative care we have access to through health care. We do end up covering them through the emergency room and uncompensated care and through our own tax dollars.”
THE UNISURED RATE FOR HEALTHCARE INCREASED IN 17 STATES LAST YEAR, THE FIRST INCREASE SINCE THE AFFORDABLE CARE ACT WAS ESTABLISHED. THE NUMBERS COINCIDE WITH PRESIDENT TRUMP AND REPUBLICANS IN CONGRESS WORKING TO REPEAL OR OTHERWISE DIMINISH THE ACA. JOINING US NOW IS SWAPNA READY FROM ASU. THANKS FOR JOINING US. UNINSURED RATE INCREASES IN 17 STATES, 12.7% END OF 2016. IT'S 15.5%. WHAT'S GOING ON?
SWAPNA REDDY: IT'S A GREAT QUESTION. IT'S A DISTURBING TREND. IT'S NOT THE DIRECTION WE WANT TO SEE FOR UNINSURANCE RATES WHEN WE SEE WHAT INSURANCE DOES TO COST IN THE UNITED STATES, HEALTHCARE IN THE UNITED STATES AND THOSE THAT NEED IT MOST. THERE ARE MANY REASONS WHY THE NUMBERS ARE GOING UP. A FEW OF THEM, PEOPLE ARE CONFUSED AS TO WHAT IS AVAILABLE. IS THE AFFORDABLE CARE ACT A LAW? IS IT SOMETHING THEY HAVE ACCESS TO. THERE IS A LOT OF CONFUSION.
TED SIMONS: IS IT STILL A LAW? IS IT SOMETHING THEY HAVE ACCESS TO?
SWAPNA REDDY: IT IS THE LAW OF THE LAND, AND YET, PEOPLE HAVE ACCESS TO IT. THERE IS A BIT OF AN ASTERISK TO IT. IN 2017, PRESIDENT TRUMP AND THE REPUBLICAN CONGRESS WENT THROUGH MOTIONS TO REPEAL AND REPLACE THE AFFORDABLE CARE ACT. WHILE THEY WERE UNSUCCESSFUL IN BEING ABLE TO LEGISLATE REPEAL AND REPLACE, MOST PEOPLE COULDN'T FOLLOW WHAT WAS GOING ON BECAUSE SO MUCH WAS GOING ON AND IT LED TO A LACK OF CONFIDENCE ON WHETHER THE LAW IS STILL IN PLACE.
TED SIMONS: FOR A LOT OF FOLK, EVEN NOW, THIS IS TOO EXPENSIVE FOR THEM.
SWAPNA REDDY: ABSOLUTELY. ONE THING WE SAW IN 2016-17 WE SAW HUGE SPIKES IN PREMIUMS. ARIZONA WAS A CENTRAL PLACE WE SAW THE SPIKES IN PREMIUMS, MAKING INSURANCE VERY EXPENSIVE FOR THOSE THAT NEEDED IT. WE ALSO SAW AN EXODUS FROM A LOT OF INSURERS FROM THE MARKETPLACE. THOSE THAT WERE LEFT NEEDED COMPETITION EXPENSIVE.
TED SIMONS: A LOT OF THIS HAS TO DO WITH THE ELECTION OF PRESIDENT TRUMP WHO HAS VOWED TO GET RID OF THE AFFORDABLE CARE ACT. WE HAVE A PANEL IN THE GALLUP POLL AND UPTICK IN UNINSURED RATE AFTER PRESIDENT TRUMP, ELECTED 10.9 NOW 12.2. IT'S AN INTERESTING GRAB. LOOK HOW HIGH IT WAS BEFORE THE AFFORDABLE CARE ACT. IT'S SLOWLY INCREASING. WITHOUT GETTING TOO MUCH INTO THE POLITICAL ASPECT OF THIS, OR WE CAN, THE FACT IS THAT REPUBLICANS IN CONGRESS DON'T LIKE THE AFFORDABLE CARE ACT. THEY WANT IT OUT OF HERE, AND IT'S MAKING A DIFFERENCE.
SWAPNA REDDY: THIS WAS A CAMPAIGN PROMISE FOR THE PRESIDENT RUNNING FOR PRESIDENT OF THE UNITED STATES. THERE ARE PROVISIONS POPULAR WITH THE PUBLIC. WHILE THE OBAMA CARE CONCEPT MIGHT NOT BE POPULAR, NOT DISCRIMINATING BASED ON PREEXISTING CONDITIONS, COVERING PEOPLE UP TO AGE 26 ARE INCREDIBLY POPULAR. PEOPLE IN TOWN HALLS ACROSS THE UNITED STATES, MAYBE PRIOR TO UNDERSTANDING WHAT WAS HAPPENING WITH THE LEGISLATION WANTED TO REPEAL THE A-C-A, WHEN THEY FOUND OUT THEY APPLIED TO THEM, THEY DIDN'T WANT THEM REPLACED.
TED SIMONS: AMONG THE UNINSURED, IT'S AFFECTING REPUBLICANS MORE THAN DEMOCRATS. THE UNINSURED ADULTS THAT IDENTIFY AS REPUBLICANS IS HIGHER THAN 2016. A LOT OF THESE FOLKS MAY BE CHOOSING ALONG I DEAL LOGICAL LINES CHOOSING TO REJECT THE AFFORDABLE CARE ACT.
SWAPNA REDDY: IT HAD AN IMAGE PROBLEM EVEN PRIOR TO THE ELECTION OF PRESIDENT TRUMP. WE WERE CONVINCING THOSE THAT NEEDED INSURANCE TO ENROLL THROUGH THE MARKETPLACE, THROUGH THE GOVERNMENT WEBSITE. THAT EXISTED PRIOR TO THE ELECTION. WITH REPEAL AND REPLACE, AND REPEAL OF THE INDIVIDUAL MANDATE, THROUGH THE TAX PLAN, THE IMAGE OF A-C-A IS HURTING QUITE A BIT AFFECTING THOSE THAT NEED IT IN TERMS OF IF THEY ARE ENROLLING OR NOT.
TED SIMONS: SHORTCUTS.
SWAPNA REDDY: 90% REDUCTION IN ADVERTISING BUDGET OUTREACH. I THINK THAT HURTS THOSE THAT NEED IT MOST AND NEED THE MOST INFORMATION ABOUT HOW TO ENROLL.
TED SIMONS: ARE THE NUMBERS SURPRISING TO YOU?
SWAPNA REDDY: THEY ARE DISAPPOINTING. FROM THE PERSPECTIVE OF KNOWING THAT HEALTH INSURANCE BENEFITS THE HEALTH OF THE PUBLIC, KNOWING THAT HEALTH INSURANCE REDUCED COST AT A FEDERAL LEVEL, KNOWING WHAT IT DOES FOR FAMILIES, KNOWING WHAT IT DOES FOR THOSE WORKING AND STRUGGLING TO MAKE END'S MEET, THE NUMBERS ARE DISAPPOINTING AND NOT THE DIRECTION THE COUNTRY NEEDS TO GO.
TED SIMONS: WHERE WILL THE PEOPLE GET HEALTH CARE? WILL THEY WIND UP IN EMERGENCY ROOMS? DO WE GO TO THE UNCOMPENSATED EMERGENCY ROOM AGAIN?
SWAPNA REDDY: I DON'T KNOW WHERE THEY'LL GO. WHEN PEOPLE NEED HEALTH INSURANCE, THEY DON'T JUST DISAPPEAR. A LOT OF TIMES THEY GET SICKER BECAUSE THEY DON'T HAVE PREVENTATIVE CARE. WE COVER THEM THROUGH THE EMERGENCY ROOM AND THROUGH OUR OWN TAX DOLLARS. WHAT YOU ARE SEEING WITH THAT AND THESE NUMBERS, AND THE GENERAL PICTURE, WHAT DOES IT SUGGEST FOR THE FUTURE OF HEALTHCARE IN THIS COUNTRY?
TED SIMONS: IT SOUNDS LIKE WE ARE GOING IN FOUR DIRECTIONS. WHERE ARE WE HEADED?
SWAPNA REDDY: IT'S IMPORTANT FOR THOSE THAT ARE DISENABLING THE AFFORDABLE CARE ACT RIGHT NOW TO COME UP WITH REPLACEMENT PLANS. WE'LL SEE HIGHER AND HIGHER NUMBERS OF LESS ENSURED AND MORE COST.
TED SIMONS: MANY SAY LET THE MARKET HANDLE THIS. CAN THE MARKET HANDLE SOMETHING THIS COMPLEX AND ALL ENCOMPASSING?
SWAPNA REDDY: THE MARKET WAS HANDLING IT AND WE HAD UNINSURANCE RATES AT 18%. IT'S HARD TO HAVE A FREE MARKET CONVERSATION TALKING ABOUT HEALTHCARE BECAUSE WE ARE TALKING ABOUT HUMAN BEINGS AND THEIR FAMILIES. IT'S DIFFICULT TO GO BACKWARDS. MANY PEOPLE ARE FAVORABLE TOWARD PROVISIONS MENTIONED EARLIER. THEY FEEL THEY DESERVE THE PROVISIONS AND PROTECTIONS. THOSE IN POWER AT THE MOMENT NEED TO LOOK TOWARD VIABLE PLANS.
TED SIMONS: GOOD TO HAVE YOU HERE. NEXT ON AS ASSIST HORIZON, WE TALK TO THE AUTHOR OF A BOOK ON HOW THE WEST SHAPED A YOUNG THEODORE ROOSEVELT.
Swapna Reddy: ASU School for the Science of Health Care Delivery