Nearly 30 Million Americans Went Without Health Coverage Last Year. Then the Pandemic Hit.



By Emiene Wright

September 16, 2020

The most impacted group, according to Census data, appears to be children.

Despite the Trump administration’s claims of building a robust economy, newly released federal data shows that even before the pandemic, the number of Americans without insurance was on the rise. That number will only grow if President Donald Trump’s plan to take down the Affordable Care Act (ACA) succeeds.

The Census Bureau recently released data from 2019 showing that 26 million people went completely without health coverage in 2019. Others only had health care part of the year, bringing the total up to 9.2% of Americans, or 29.6 million, who were not covered by health insurance at the time of interview. That’s an increase of roughly 1 million from the 28.6 million who were uninsured in 2018. The number of people with Medicaid coverage also fell by 2.4 million between December 2017 and December 2019. 

The continued loss of health coverage has eroded the gains made since the passage of the Affordable Care Act, which made insurance attainable for 20 million people since President Barack Obama introduced it 10 years ago. Nineteen states saw declines in coverage last year. Virginia was the only state to record an increase in the number of people with insurance, and that can be largely attributed to its expansion of Medicaid under the ACA. 

RELATED: ‘Absolute Game Changer’: How the Affordable Care Act Helped Save the Lives of People With HIV

The picture worsens when the impact of COVID-19 is taken into account. Going into the pandemic, 2.3 million more people were uninsured than in 2016, including over 700,000 children, according to the Center on Budget and Policy Priorities. The resulting unemployment crisis booted millions more off of job-based coverage plans and made it even more difficult for Americans to afford care. 

Several Trump policies can be credited with the current state of affairs. In August 2019, the administration ruled officials could deny citizenship to legal immigrants who had received or might apply for public benefits such as Medicaid, likely lowering enrollment in public coverage programs and raising uninsured rates. Hispanics and Latinos reported an increased uninsured rate of 17.9% in 2018 to 18.7% in 2019, the largest jump of any racial or ethnic group.

The ACA’s individual mandate that required most people to have coverage or pay a penalty was also repealed in 2019, depressing the number of middle-income people who otherwise would have enrolled for coverage.

Among the insured, research showed that if their medical bills were counted, about 7.7 million more people would be considered poor. The United States remains the only wealthy, industrialized nation in the world that does not guarantee universal health care for its citizens.

The most impacted group, according to Census data, appears to be children. Across all socioeconomic levels, more and more youth are going without insurance, but those living below the poverty line are suffering the most. The overall uninsured rate for all children increased 0.5 percentage points to 5.7%, but poor kids’ uninsured rate jumped nearly a full percentage point, to 7.4%. 

The census numbers add vital context to the debate over the ACA, which could be facing extinction this fall if a lawsuit backed by Trump is successful. This year, while millions were infected and tens of thousands died, Trump repeatedly voiced support for repealing the program while offering no true alternative

RELATED: The GOP Wants to Repeal the ACA During a Pandemic. Democrats Are Trying to Expand Coverage.

In a July 19 interview on Fox News Sunday, Trump told Chris Wallace he would sign a “full and complete health care plan” within two weeks. 

But Wednesday, testifying before a Senate Appropriations subcommittee on the federal response to the coronavirus crisis, top health care officials in the Trump administration said they are not aware of a health care plan to replace the Affordable Care Act.

Dr. Robert Kadlec, assistant secretary for preparedness and response, said a new healthcare proposal is “not in my portfolio” and he has no awareness of one, while Centers for Disease Control and Prevention Director Dr. Robert Redfield said a plan is “not in my main lane, but I’m not aware of one.”



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