In the drive to ensure that all Americans have access to affordable and comprehensive health care, reform advocates have defined the uninsured population as 47 million, or approximately 15% of the population. More recently, President Obama has been referring to “over 30 million”. The lower number, it turns out, stems directly from Obama’s need to assuage critics concerned that his proposals provide coverage for undocumented illegal aliens. See Reuters article.
If the President’s #1 stated goal is to make sure that all Americans have access to affordable health insurance, it stands to reason that we should have a pretty decent understanding of this population. The better we understand who they are and the reasons why they do not have coverage, the more effective we can be is developing solutions to address the problem… ground-breakingly obvious, wouldn’t you say??
In any case…the leadership team at Aetna, led by Ron Williams and Mark Bertolini, has done a great job of defining this population and looking for creative ways to address the coverage issue. The numbers look like something like this:
Total U.S. population: 299.1 million
Insured through employers: 177.3 million
Individual plans: 26.6 million
Medicare/Medicaid: 83 million
Total Uninsured: 45.7 million
Non-US Citizens: 7.5 million
Eligible for Medicaid/not enrolled: 11 million
Uninsured students: 4.5 million
< $50,000 income: 28 million*
>$50,000 income: 17.6 million
*includes Medicaid group above
SOURCE: Personal analysis and interpretations from various sources including Aetna and Kaiser Family Foundation (KFF)
With this understanding, we can contemplate a few simple reforms that would substantially eliminate the problem:
1. Get the 11 million ENROLLED in Medicaid
2. Adopt an IMMIGRATION/CUSTOMS requirement that all non-resident visitors prove they cave coverage in their home country
3. Institute a federal mandate that all residents maintain coverage:
- Require colleges to make STUDENTS document coverage before enrolling
- Provide subsidies or Tax credits to the <$50,0000 POPULATION
- Institute tax penalties for those over $50,000 to ensure they BUY COVERAGE
The cost for these reforms would be a fraction of the $1 trillion programs being debated in congress. In fact, according to Aetna, we could give FREE COVERAGE to the entire uninsured population for a mere $214 billion…still a fraction of what Congress is proposing.
Do these numbers surprise you? They surprised me a bit.
Do you know anyone who is uninsured today? Can you share their story with me?
