Amid roiling health care debate, the share of uninsured Americans is growing

JUDY WOODRUFF: One of the biggest issues in
the 2020 presidential campaign is about expanding health coverage or not. Millions of Americans are at that time of
year when they have to decide whether to get their coverage through the marketplaces created
during the Obama years. Amna Nawaz looks at this moment. AMNA NAWAZ: Judy, several reports find the
percentage of uninsured Americans is rising for the first time since the Affordable Care
Act took effect. That increase is backed up by Census Bureau
data. But experts are asking, why are those numbers
rising? We’re going to look at that question and this
enrollment season. But, bear in mind, as this plays out, President
Trump says he remains committed to killing the Affordable Care Act and has backed a state
lawsuit to do so. At the same time, it’s the law of the land. The president also says he wants to cover
people with an alternative that would offer some of the same consumer protections and
lower health care premiums. But he has not offered any new plan yet. For more on this, Margot Sanger-Katz joins
me here now. She reports on all of this for The New York
Times. Welcome back to the “NewsHour.” MARGOT SANGER-KATZ, The New York Times: Thanks
for having me. AMNA NAWAZ: So, let’s just start with where
we are. We’re a couple of days into the enrollment
season. How are things looking so far? MARGOT SANGER-KATZ: So, despite everything
you said, the Trump administration is no fan of Obamacare, but this year looks pretty good. Compared to last year, there are more choices
in a lot of parts of the country, and premiums actually have come down a little bit. And it’s been this interesting sort of boomerang. When the Trump administration came in, they
did a whole bunch of things that made those markets really bumpy and problematic. Prices went way up. A lot of insurers left the market. There was a lot of concern and policy uncertainty. And then, over time, things have kind of stabilized,
and so we’re kind of correcting back to a more normal, stable place. AMNA NAWAZ: Let me ask about this number that’s
catching everyone’s attention now, the overall number of Americans who are uninsured. Take a look at this number and the increase. From 2017, it was 7.9 percent of the American
public who were uninsured. That went up in 2018 to 8.5 percent. That’s about 27.5 million people. The economy is doing well. You wouldn’t expect to see these numbers. What’s happening there? MARGOT SANGER-KATZ: Yes, I mean, I think this
is a pretty troubling development. It’s been about a decade since we have really
seen the uninsured rate go up. So it’s not just Obamacare, but even before
then. And, generally, as you say, when the economy
is doing better, more people have jobs that give them coverage. And I think there are a couple of different
things that are going on here. One has to do with things that states are
doing in their Medicaid programs, where they’re making a little bit harder for people to get
enrolled and stay enrolled. And that’s something that is not an explicit
federal policy, but the Trump administration has made it a little bit easier for states
to do those sorts of things. I think another major possible source of these
coverage losses are concerns about immigration policy, where a lot of families where there
might be children who are U.S. citizens and parents who are either undocumented immigrants
or even legal immigrants who are in the process of getting their green card or their citizenship,
they may be more reluctant to sign up for public coverage because they’re worried that
it may affect their immigration status. And then I think there’s this third category
that’s linked to the Obamacare markets that we talked about earlier. The premiums for Obamacare plans are really
high. They have risen a lot over the course of the
program. And there are people who do not qualify for
any financial assistance buying those plans. And we can see that more than a million people
have basically left that market because they have decided that it’s too expensive. AMNA NAWAZ: There’s another subgroup you have
looked at in your reporting that caught my attention because of another alarming number. You looked at the number of children who no
longer have health insurance. And this is, as you reported, the number of
children without Medicaid or health insurance. That number increased by more than a million
between 2016 and 2018. What is happening there? Why children? MARGOT SANGER-KATZ: So, again, I think this
is a little bit of a complicated portrait, but it is a really, really worrisome sign,
more so even then insurance coverage for adults. We know that there are huge public health
and economic benefits for children having health insurance. So kids that have Medicaid are more likely
to be healthy when they’re older. They’re more likely to finish high school
and college. They’re less likely to have children themselves
as teenagers. And there’s even some evidence that they earn
more income as adults. So I think it’s a combination of various factors. As I said, I think some states are taking
actions that is making it harder for families to enroll their children in Medicaid or to
keep them enrolled. And I do think that there’s a lot of concern
among immigrant families. My colleague Abby Goodnough went to Houston,
Texas, and talked to some immigrant families where they had kept their kids in Medicaid
for many years, and then were starting to disenroll them because they were worried it
could affect their legal status. AMNA NAWAZ: So the question everyone has after
all of this — this is the question everyone’s asking right now in this political climate
— is, what plan and what kind of health care system should we have? You and your colleagues at The New York Times
partnered with the Commonwealth Fund and with Harvard, and you asked that question of a
number of Americans. You surveyed a number of people and said,
what is the kind of plan that you think you would like? What you found was basically a three-way split
between a Medicare-for-all-type plan and Obamacare-plus, right, Affordable Care Act-enhanced, and then
a Republican plan, which would be less federal government involvement, more money and more
resources to states. And that — I should say, those numbers all
fall within the margin of error. So it’s basically a three-way split. What does that tell you? MARGOT SANGER-KATZ: I think, first of all,
it tells us there about two-thirds of Americans or at least 60 percent of Americans that favor
sort of Democratic solutions. And that’s consistent with other polling,
where we see that people tend to trust the Democratic Party a little bit more on health
care. There’s only a third that are really enthusiastic
about the plan that President Trump is talking about. But among people favoring those more Democratic
options, there is a real divide. And I think we see that in the Democratic
primary contest, where some candidates really want to do Medicare for all, a sort of single-payer
system where everyone gets their insurance from the government. And then there are some candidates that want
to try to figure out, how do we work within the existing system to fill in holes and to
cover some of these people that are falling through the cracks? And I think we’re going to continue to see
that debate going on through this primary and probably into the general election as
well. AMNA NAWAZ: It remains a top issue for American
voters out there. Margot Sanger-Katz of The New York Times,
thanks so much for being here. MARGOT SANGER-KATZ: Thank you so much for
having me.

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