August 7, 2014 by Tony Novak
We can be reasonably confident that the number of uninsured people in the United States right now is somewhere between 40 and 60 million; adopting the full range of published estimates or extrapolations from published data. That’s a wide range in estimates; too wide, IMO, to be useful for most purposes. Yesterday I published a blog post using an estimate of 45 million people and noted that this number was relatively unchanged from a decade earlier. My estimate was just that, an estimate. But given the range of estimates, this post provides further basis for the number that I used.
Perhaps the most reliable and current data comes from the April 2014 Gallop poll result (http://www.gallup.com/poll/168248/uninsured-rate-lowest-2008.aspx) saying that 15.6% of Americans were uninsured in the first quarter of 2014. These results come from more than 43,500 interviews with U.S. adults from Jan. 2 to March 31, 2014, as part of the Gallup-Healthways Well-Being Index. If we use a conservative population estimate of 320 million people in the U.S. at this point of measurement, that means that about 50 million people are currently uninsured (320,000,000 x .156 = 49,920.000).
The Congressional Budget Office (CBO) published an earlier estimate, now often quoted by the Department of Health and Human Services in its marketing materials for the Affordable Care Act, that the number of uninsured will drop to 30 million uninsured by 2016. I’m not convinced that this is a reasonable assumption anymore especially in light of the legal challenge to the insurance subsidies in most states that will likely wind up as a Supreme Court case.
Recent news that IRS is now scrutinizing hundreds of thousands of individual premium subsidies claimed but not deserved has created a second source of hesitancy and additional pressure on insurance enrollment.
A third source of upward pressure on the number of uninsured comes from small businesses and their employees who become stymied with their current options and some, unfortunately, just drop their coverage. This topic is covered in today’s Wall Street Journal that includes my bit of advice “Most small firms would be better off financially by canceling group coverage and giving taxable bonuses to let employees purchase coverage on the individual market,” Too many small business employers do not give taxable bonuses for individual insurance or provide additional resources to encourage employees to enroll in alternative coverage.
On top of all this, a new report of potential technical glitches surfaced yesterday (8/6/2014 with no citable source yet) that is predicted to affect the insurance exchanges in 2015.
We can reasonably estimate that all of this continued frustration and uncertainty will extend public hesitancy about enrolling through the insurance exchanges over the coming year. My guess is that we will find the uninsured to be stubborn and persistent, and that 45 million will wind up being closer the adjusted figure of uninsured Americans in 2016.
The measurement of this figure is particularly important to be because two of my businesses Freedom Benefits and OnlineNavigator focus on serving the unique needs of middle-class Americans without health insurance.
Since we understand that different groups have motives for distorting this crucial figure, I feel that it is particularly important for news reporters covering this topic to explain their source of data. I hope that other media sources do a deeper dive on the data and this important forecast.