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Editorial: Trump, GOP succeed in making it harder for Americans to get health care

  • The number of Americans who lacked health insurance rose last year for the first time since the Affordable Care Act became law in 2010. (Dreamstime/TNS)

Published: 9/14/2019 10:10:09 PM
Modified: 9/14/2019 10:10:07 PM

A new report by the Census Bureau affirms that the health care policy being pursued by President Donald Trump and his Republican allies in Congress is working as intended: The number of Americans who lacked health insurance rose last year for the first time since the Affordable Care Act became law in 2010.

About 27.5 million Americans went without health insurance for all of 2018. That’s 8.5% of the population, up from 7.9% percent the previous year. Before the ACA was passed, establishing new insurance markets and providing financial subsidies, more than 15% lacked coverage.

Admittedly, it is hard to fathom why it would be the policy of any political party to deprive people of the means to obtain health care, but it is hard to reach any other conclusion under the circumstances.

The New York Times reports that among the steps the Trump administration has taken to undermine the ACA are these: Cutting back on the advertising and enrollment assistance that helps low-income people learn about their insurance options and exercise them; announcing that Medicaid enrollment would be held against immigrants seeking citizenship or green cards; ending a subsidy program, which in turn contributed to big price increases in the marketplaces in many areas; urging states to bring greater scrutiny to bear on Medicaid eligibility, creating new layers of red tape that may have suppressed enrollment. (And perhaps led some states to enact work requirements such as the ones imposed in New Hampshire, which are currently stayed by a federal judge).

Republicans in Congress played their role in the 2017 tax giveaway by abolishing the individual mandate that required people to obtain coverage or pay a fine. Although that provision didn’t kick in until this year, publicity about it is thought to have played a role in people abandoning their insurance coverage.

The trend reversal in the number of people with coverage is especially striking in that it occurred in the midst of an economic boom and very low unemployment. Normally, health coverage increases when the good economic times are rolling, because employer-based coverage increases — and most Americans get health insurance coverage through the workplace. What happens when the next recession comes along and the employment numbers shrink?

A separate report this month by the Government Accountability Office demonstrated what many have long suspected: that wealthy people live longer than poor people. The link between greater wealth and income and increased longevity was studied among people born between 1931 and 1941. Nearly 75% of those with incomes in the top 20% of mid-career earnings were still alive in 2014, compared with just 52% of those in the bottom 20% of mid-career earnings. Certainly, many reasons contribute to such a disparity, but who can doubt that lack of access to health care accounts for a big part of it?

Democratic presidential candidates are debating whether the right course is to shore up the Affordable Care Act, which is imperfect but has been effective, or to move to a universal health care system. There are good arguments for and against each.

By contrast, we are as yet unaware of a serious Trump health care plan or any proposal for an alternative to Obamacare that enjoys broad support among Republicans in Congress, other than to cripple it or nullify it through the courts. There are no good arguments for that approach.

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