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After the delay of a vote on the Senate’s controversial health bill, White House Press Secretary Sean Spicer took to Twitter to assuage concerns regarding the increase in the uninsured population projected by a Congressional Budget Office report.
Spicer tweeted an image that said, "28.2 million Americans are still waiting under Obamacare and remain uninsured!"
We checked the National Center for Health Statistics and found that 28.2 million people were indeed uninsured as of 2016. We also found, however, that the tweet neglects to show the full picture.
The same bullet point Spicer seems to quote points out that we have 20.4 million fewer uninsured people since 2010, the year the Affordable Care Act went into effect. The current 8.8 percent rate of uninsured persons is the lowest since 1972.
"Nor did he mention that the Senate bill would result in approximately zero of the 28.2 million currently uninsured becoming insured. Quite the opposite," said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University.
The Senate bill would bring the non-elderly uninsured population to 49 million, and the House bill to 51 million by 2026; both numbers are quite higher than the 28.2 million currently uninsured.
While there was never the expectation that the ACA would bring the number of uninsured Americans down to zero, there is a viable argument that the ACA did not do enough to expand coverage. But neither bill proposed in Congress now would reverse this trend.
"While there are proposals that could reduce the number of uninsured — including expanding Medicaid in more states and providing more generous financial assistance to people buying coverage on the individual market — those are generally policies that the administration and its congressional allies have opposed," said Matt Fiedler, a fellow with the Center for Health Policy in Brookings' Economic Studies Program.
The states that elected not to expand Medicaid coverage account for about 2.6 million of the uninsured population, according to Kaiser Family Foundation Executive Vice President Diane Rowland.
That number may increase because the Senate bill cuts federal assistance to Medicaid. States that have opted into the expansion program might begin scaling back coverage.
According to the CBO, "despite being eligible for premium tax credits, few low-income people would purchase any plan."
The 3 million people who are uninsured because they make too much money for subsidies will not be covered, either, as the poverty level that qualifies people for subsidies is increasing.
"It would lower the subsidy levels and it would make them much more costly for older people who are pre-Medicare, so you would expect fewer of them to try to take up coverage and many who have coverage to drop it," Rowland said.
The 5.4 million people uninsured because they are undocumented will remain uninsured, too, as the Senate bill doesn’t cover undocumented people.
About 4.5 million people now who could get insurance through work go without it. The bill removes the employer penalty, so coverage provided through work would decrease further.
"It’s basically prohibiting anyone who has an offer of employer coverage from being able to get a tax credit, so it wouldn’t help any of the people who can’t afford their employer coverage," Rowland said.
Finally, the remaining 12 million people who are eligible for coverage but haven’t participated is expected to grow, as the Senate bill eliminates the individual mandate that was designed to lure those people in.
Spicer said that 28.2 million Americans remain uninsured under Obamacare, an accurate claim based on the most recent numbers. However, the talking point is out of context, as it ignores that this is in fact a historic low in the United States.
He suggests that repealing the ACA would decrease this figure, but the CBO and health care experts agree that the opposite would happen under the proposed House and Senate versions of the health care bill.
We rate this statement Half True.
Tweet, Sean Spicer, June 28, 2017
Email interview with Steven Cheung, special assistant to the president and assistant communications director, June 28, 2017
Phone interview with Diane Rowland, executive vice president of the Kaiser Family Foundation, June 28, 2017
Email interview with Sherry Glied, the dean of New York University’s graduate school of public service, June 28, 2017
Email interview with Matthew Fiedler, a fellow with the Center for Health Policy in Brookings' Economic Studies Program
Email interview with Sabrina Corlette, research professor at Georgetown University’s Health Policy Institute, June 28, 2017
Email interview with Ben Sommers, an associate professor of health policy and economics at Harvard University, June 28, 2017
CBO, "CBO’s Analysis of the Major Health Care Legislation Enacted in March 2010," March 30, 2011
CBO, "H.R. 1628 Better Care Reconciliation Act of 2017 cost estimate," June 26, 2017
Bloomberg, "Why 27 Million Are Still Uninsured Under Obamacare," Oct. 19, 2016
National Center for Health Statistics, "Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2016," Feb. 2017
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