27.5M Amer­i­cans with­out health cov­er­age

Cen­sus Bureau data show share rises for 1st time in a decade

Baltimore Sun - - NATION & WORLD - By Christo­pher Rugaber and Ri­cardo Alonso-Zal­divar

WASH­ING­TON — The proportion of Amer­i­cans with­out health in­sur­ance edged up in 2018 — the first evidence from the govern­ment that cov­er­age gains un­der Pres­i­dent Barack Obama’s health care law might be erod­ing un­der Pres­i­dent Don­ald Trump.

The Cen­sus Bureau also said in an an­nual re­port Tues­day that house­hold in­come rose last year at its slow­est pace in four years and fi­nally matched a pre­vi­ous peak set in 1999. Me­dian house­hold in­come in­creased 0.9% in 2018 to an in­fla­tion-ad­justed $63,179, from $62,626 in 2017.

The data sug­gest that the eco­nomic ex­pan­sion, now the long­est on record at more than 10 years, is strug­gling to pro­vide wide­spread ben­e­fits to the U.S. pop­u­la­tion. Solid gains in house­hold in­comes over the past four years have re­turned the me­dian only to where it was two decades ago. And de­spite strong growth last year in the num­ber of Amer­i­cans work­ing full time and year­round, the num­ber of peo­ple with pri­vate health in­sur­ance re­mained flat.

One bright spot in the re­port was that the poverty rate fell for a fourth straight year to 11.8%, its low­est point since 2001. The proportion of house­holds led by women that were poor fell to a record low.

“While any re­duc­tion in poverty or in­crease in in­come is a step in the right di­rec­tion, most fam­i­lies have just barely made up the ground lost over the past decade,” said Elise Gould, se­nior econ­o­mist at the lib­eral Eco­nomic Pol­icy In­sti­tute.

Though in­come in­equal­ity nar­rowed last year, it re­mains near record lev­els reached in 2017. Last year, the richest 5% of the U.S. pop­u­la­tion cap­tured 23% of house­hold in­come.

Still, steady hir­ing and an un­em­ploy­ment rate at 3.7%, near a five-decade low, have helped raise earn­ings for lower-paid work­ers em­ployed by restau­rants, ware­houses, ship­ping cen­ters and other sec­tors of the econ­omy. This trend has con­trib­uted to a de­cline in poverty.

On health in­sur­ance, the Cen­sus re­port found an es­ti­mated 27.5 mil­lion peo­ple, 8.5% of the pop­u­la­tion, with­out cov­er­age in 2018. That was an in­crease of 1.9 mil­lion unin­sured peo­ple, or 0.5 per­cent­age point.

More peo­ple were cov­ered by Medi­care, re­flect­ing the ag­ing of the baby boomers. But Med­i­caid cov­er­age de­clined. The num­ber of unin­sured chil­dren also rose, and there were more unin­sured adults ages 35-64.

Though the in­crease in the num­ber of unin­sured Amer­i­cans was mod­est, it could be a turn­ing point, the first real sign that cov­er­age gains un­der Obama could be at least partly re­versed. This year, the num­ber of unin­sured could rise again. That’s be­cause a pre­vi­ous Repub­li­can-led Congress re­pealed fines un­der the Af­ford­able Care Act that had been in­tended to nudge peo­ple to sign up for cov­er­age.

The Cen­sus re­port is sure to play into 2020 pres­i­den­tial pol­i­tics. Health care is the lead­ing is­sue for Democrats, with pro­pos­als in­clud­ing Sen. Bernie San­ders’ call for a gov­ern­men­trun sys­tem to cover ev­ery­one and for­mer Vice Pres­i­dent Joe Bi­den’s idea for ex­pand­ing Obama’s law and adding a govern­ment plan open to vir­tu­ally any­one.

Democrats are lay­ing the blame Trump, long ac­cus­ing his ad­min­is­tra­tion of de­lib­er­ately un­der­min­ing Obama’s health care law. House Speaker Nancy Pelosi on Tues­day blamed Trump’s “cruel health care sabotage” for the ris­ing num­ber of unin­sured peo­ple. In a state­ment, the Cal­i­for­nia Demo­crat said Trump’s on­go­ing ef­forts to erode Obama’s law have forced Amer­i­cans to “live in con­stant fear of an ac­ci­dent or in­jury that could spell fi­nan­cial ruin for their fam­i­lies.”

Trump spent most of his first year in of­fice un­suc­cess­fully try­ing to get a Repub­li­can Congress to re­peal the Af­ford­able Care Act. He is now ask­ing a fed­eral ap­peals court to over­turn it as un­con­sti­tu­tional. The pres­i­dent also slashed the pro­gram’s signup sea­son ad bud­get and scaled back fund­ing to help peo­ple nav­i­gate t he en­roll­ment process. Trump also re­moved a sub­sidy for in­sur­ers, thereby trig­ger­ing a jump in pre­mi­ums.

Yet ACA en­roll­ment has held fairly steady, with about 20 mil­lion peo­ple cov­ered by its mix of sub­si­dized pri­vate plans and a Med­i­caid ex­pan­sion for low-in­come in­di­vid­u­als. The Cen­sus re­port found that Med­i­caid cov­er­age de­clined by 0.7% from 2017.

The Trump ad­min­is­tra­tion has also rolled out some reg­u­la­tory changes of its own in­tended to ex­pand cov­er­age. Th­ese in­clude “as­so­ci­a­tion health plans” for small busi­nesses, short-term plans for in­di­vid­u­als and new op­tions for em­ploy­ers to help fi­nance work­ers’ cov­er­age. Th­ese changes are fairly re­cent, though, and it’s un­clear what im­pact they might even­tu­ally have.

KEITH SRAKOCIC/AP 2018

The Cen­sus Bureau also said house­hold in­come rose at its slow­est pace in four years, but matched a peak set in 1999.

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