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16 Million Uninsured Disappeared Last Night — Where Did They Go?

The President has consistently said that 46 million Americans lack health insurance. But last night, he said, “There are now more than 30 million American citizens who cannot get coverage.” 

Explanations range from excluding illegal immigrants, people who are eligible for Medicaid but not enrolled, and those who are not poor or near poor. The problem is that if the Administration actually added these numbers, they would total far more than 16 million. The administration says there are about 10 million illegal immigrants who wouldn’t be eligible. While the administration says 5−7 million people are eligible for Medicaid but not enrolled, Kaiser (pg. 3) found that “a quarter of the uninsured (11 million) are eligible for public programs but not enrolled.” And if you only include the poor or near poor (defined as people below 200 percent of FPL, according to another estimate from Kaiser (pg. 4)), that would exclude about 15 million people who earn more than 200 percent FPL. So adding up these categories, this would exclude 36 million people from the 46 million uninsured, putting the number closer to 10 million people who cannot get affordable coverage. It is unclear where the Administration got their numbers, but it’s a positive step that they are acknowledging that the uninsured are not all the same.

Gaming Mass. Health Care

This is from the Wall Street Journal:

Harvard-Pilgrim CEO Charlie Baker reports that his company has seen an "astonishing" uptick in people buying coverage for a few months at a time, running up high medical bills, and then dumping the policy after treatment is completed and paid for. Harvard-Pilgrim estimates that between April 2008 and March 2009, about 40% of its new enrollees stayed with it for fewer than five months and on average incurred about $2,400 per person in monthly medical expenses. That's about 600% higher than Harvard-Pilgrim would have otherwise expected.  The individual mandate penalty for not having coverage is only about $900, so people seem to be gaming the Massachusetts system. "This is a problem," Mr. Baker writes on his blog, in the understatement of the year. "It is raising the prices paid by individuals and small businesses who are doing the right thing by purchasing twelve months of health insurance, and it's turning the whole notion of shared responsibility on its ear."

CBO Dissects the Kennedy/Dodd Bill

The Congressional Budget Office (CBO) appeared this morning before the HELP committee to answer questions about its analysis of the Kennedy/Dodd bill. There are a few important takeaways from CBO's comments:

  1. The Kennedy/Dodd bill will increase spending by more than $1.2 trillion, and this doesn't include the 10-year cost of the plan when fully implemented.The bill includes $723 billion in new spending, not including the $500 billion cost of expanding Medicaid assumed in the bill. CBO agreed with Senator Burr when he pointed out that the estimate includes only 6 years of full implementation of the program.
  2. If you like what you have, you can't keep it. The CBO confirmed that several million Americans would lose their employer-based health insurance they have now if Kennedy/Dodd becomes law.
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