CDC: Uninsured rate holds steady one year into Trump era

The U.S. uninsured rate held steady from 2016 to 2017 despite fears that President Trump’s arrival would upend Obamacare’s coverage gains, the Centers for Disease Control and Prevention said Tuesday.

The CDC’s National Health Interview Survey found 9.1 percent of the population, about 29 million people, were uninsured, meaning the tail end of President Barack Obama’s tenure largely mirrored the situation one year into the Trump era.

However, the report found a notable increase in the number of “not poor” — or middle class — people who were uninsured, from 7.2 percent in 2016 to 8.2 percent in 2017.

This could reflect the share of people who buy insurance on their own but do not qualify for Obamacare’s taxpayer-funded subsidies, meaning they must pay full price for premiums that continue to soar.

Far fewer people — 19.3 million — are uninsured now compared to 2010, when Mr. Obama’s signature health law was passed into law.

Its coverage gains have flatlined since about 2015, as interest in its web-based exchanges stalls out and few additional states opt to expand Medicaid coverage to people making slightly above the poverty level.

Achieved gains have held steady, however, despite GOP claims the law is “imploding” and Democrats’ fears that Mr. Trump’s influence would blow up the insurance markets.

Signups on the exchanges dipped only slightly for 2018, even as Mr. Trump slashed Obamacare’s advertising budget and attacked the program as already “dead” — although his GOP allies were unable to repeal and replace the law as promised.

One caveat is that Mr. Trump’s most tangible changes to the insurance market haven’t taken effect yet.

Actuaries expect his push to repeal the individual mandate to hold insurance, effective 2019, will cause uninsured rates to rise, and that his emerging plan to let people hold onto skimpy, short-term plans for a full year could cause costs to rise of sicker people in the exchanges, forcing them out.

“I fully expect to see an increase in the number of people uninsured in 2018 and 2019,” said Larry Levitt, senior vice president at the nonpartisan Kaiser Family Foundation.

At the same time, states like Virginia are considering an expansion of their Medicaid populations under Obamacare, while Maine is trying to implement its voter-approved expansion.

The CDC found an increase in the uninsured rate among states that have resisted expansion — from 17.5 percent in 2015 to 19 percent in 2017.

By comparison, the uninsured rate stood at 9.1 percent in the dozens of states that did expand their programs.

“In states that haven’t expanded Medicaid under the [Affordable Care Act], nearly one in five adults is uninsured, and it’s been getting worse,” Mr. Levitt said. “There’s a growing disparity between states when it comes to access to insurance.”