This week I have a “Guest Columnist”. A Conservative Medical Doctor who I have the honor to call my friend, posted on his blog a great explanation of who, if any, are the millions who will be uninsured if the ACA is repealed. His name is Dr Tony Maglione and his blog is DrTonyMag. He gave me permission to share this with you.
I am getting sick and tired of the false narrative that over 22 million Americans will lose their insurance if Obamacare is repealed. I will explain how the numbers don’t add up by using a simple arithmetic method called subtraction. Before I get to the numbers, let me emphasize that being insured for your health does not mean that you are getting better or even adequate healthcare. If the deductibles are too high, many Americans will be unwilling to use their healthcare insurance because of the out of pocket costs. So the numbers of Americans insured is not the goal, rather better healthcare at an affordable price for all Americans should be the goal.
Note that the numbers of Americans that are insured varies according to the source. When researching the data from sources such as the CMS, Census Bureau, and Kaiser family foundation,(wherever I could), I used the worst-case scenario for those uninsured. For example, the number of Americans in 2017 on employer health care plans varied from 159 million to 178 million. For discussion, I used the 159 million number which would result in more uninsured. Even when you take the worst possible case scenario, the number of additional uninsured Americans is less than 13 million.
So now let’s go to the numbers. At the beginning of 2017,the US population was approximately 325 million Americans. There are approximately 50 million Americans on Medicare and over 70 million Americans on Medicaid. There are also 159 million Americans on employer healthcare plans and 10 million Americans who are VA enrollees.
If you take 325 million and subtract 159 million and then subtract 70 million and then subtract 50 million and finally subtract 10 million, that will leave 36 million who need to get their insurance from the individual healthcare market. When you consider that 28 million Americans have decided not to purchase Obamacare even though there is an individual mandate to do so; that leaves 8 million Americans who could lose their insurance once Obamacare is repealed.
If you look at Medicaid Expansion, there were less than 5 million Americans from 31 states plus D.C. who became insured from Medicaid Expansion because they were between 100 and 133% the federal poverty line (actually 138% the way government does numbers). In a replacement Bill, these 5 million Americans would be grandfathered in and protected. But, if states choose not to protect them, that would add 5 million to those 8 million on the individual market leaving a total of 13 million more uninsured Americans in the worst-case scenario. This number is almost half the number of the mainstream media and the CBO projections,which is at 22 to 24 million more Americans uninsured with Obamacare repeal. Note, these projections also do not estimate how many Americans are now losing Obamacare because there is no healthcare insurer in their states/counties. Also, if you use the best-case scenario and consider overlap coverage in a few million, the 13 million number would be substantially less.
Now let’s see how the 13 million number of more uninsured Americans, which is the worst-case scenario, is also highly exaggerated. Of the 8 million potential more Americans uninsured in the individual market, 2 million of those are on their parents plan and under the age of 26. This provision will remain in the replacement plan. Another 2 million did not require subsidies and they will be able to afford their healthcare. This now leaves only 4 million Americans in the individual plans that are vulnerable to losing their insurance.
Of the 5 million Americans who are on Medicaid, because of Medicaid expansion, 4 million of them are single adults without children who are capable of working. Therefore, 4 million could be added to the employer health care plans if they choose to work. Again simple subtraction leaves only 1 million (5 million minus 4 million) Medicaid recipients vulnerable and that is if a replacement Bill does not provide any subsidies which is not the case.
Now that I’ve shown you how the “13 million number of more uninsured Americans” is down to 5 million (4 million in individual plans and 1 million in Medicaid expansion),this number also may not be realistic. A replacement plan will offer more affordable and cheaper catastrophic plans, so most likely within 2 to 3 years, many of the 28 million Americans who chose not to buy insurance may do so because it will now be more affordable.
In the end, not only is the number of “22 million more Americans uninsured with repeal of Obamacare” a complete fabrication, it is likely that within five or six years, more Americans will be insured. We need only to add and subtract the numbers correctly and honestly to see the Real News.