The president’s healthcare law sliced America’s uninsured rate down to historic lows by expanding coverage for tens of millions of Americans. At the same time, however, the number of insured people who still lack affordable, robust coverage is rising sharply as more people buy into high-deductible policies.
A new study from the Commonwealth Fund reveals that about 23 percent of Americans with coverage are considered underinsured—up from 12 percent in 2003. That means roughly 31 million Americans who bought health insurance still have trouble affording treatment under their policies.
The researchers at the Commonwealth Fund defined “underinsured” people as having out-of-pocket costs that total 10 percent or more of their annual income, or a deductible that is 5 percent or more of their income. The study concluded that high-deductible policies are likely the culprit behind this massive influx of underinsured people.
The findings are a huge problem for the Obama administration since the entire goal was to expand access to coverage to millions of Americans that they presumably would use instead of delaying treatment. But a handful of recent studies show that even people with health insurance are delaying treatment because they can’t afford it.
A December Gallup Poll showed at least 38 percent of insured, middle-income people, said they had delayed medical treatment because of the cost. “While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost,” Gallup’s Rebecca Riffkin wrote in a post on the pollster’s website.
The shift toward cost-sharing and high-deductible policies—defined by the Internal Revenue Service as those with annual deductibles of $1,300 or more for individuals and $2,600 for families--is widespread among exchange policies but also employer plans.
The Commonwealth Foundation’s study, unsurprisingly, reveals that low-income people with coverage are about twice as likely to be “underinsured” than people earning more than 200 percent of the poverty line.
Of course, it’s important to note that while affordability continues to be an issue, significantly more people do have health insurance because of the law.
Politico’s Tim Alberta and Rachael Bade drop a blockbuster: “Despite several landmark legislative wins this year, and a better-than-expected relationship with President Donald Trump, Ryan has made it known to some of his closest confidants that this will be his final term as speaker. … He would like to serve through Election Day 2018 and retire ahead of the next Congress. This would give Ryan a final legislative year to chase his second white whale, entitlement reform, while using his unrivaled fundraising prowess to help protect the House majority—all with the benefit of averting an ugly internecine power struggle during election season.”
Speculation has been swirling that Ryan could step down once “he’s harpooned his personal white whale of tax reform,” as HuffPost put it.
When asked at his weekly press conference whether he’ll be quitting anytime soon, Ryan chuckled and said, “I’m not, no.”
The finance ministers of Europe’s five largest economies — Germany, France, the U.K., Italy and Spain — warned that the Republican tax plan could have “a major distortive impact” on international trade and may violate international treaties. "The inclusion of certain less conventional international tax provisions could contravene the U.S.'s double taxation treaties and may risk having a major distortive impact on international trade," the ministers wrote in a letter to Mnuchin.
Politico reports: “The White House is quietly preparing a sweeping executive order that would mandate a top-to-bottom review of the federal programs on which millions of poor Americans rely. And GOP lawmakers are in the early stages of crafting legislation that could make it more difficult to qualify for those programs. … The president is expected to sign the welfare executive order as soon as January, according to multiple administration officials, with an eye toward making changes to health care, food stamps, housing and veterans programs, not just traditional welfare payments.”
President Trump signed a short-term continuing resolution today to fund the federal government through Friday, December 22.
Bloomberg called the maneuver “a monumental piece of can kicking,” which is no doubt the case, but at least you’ll be able to visit your favorite national park over the weekend.
Here's to small victories!