The number of uninsured Americans remained relatively unchanged over the last year, the government said Tuesday in a report offering fresh evidence that Obamacare’s sweeping coverage gains are stalling out.
Roughly 28.1 million people, or 8.8 percent of the U.S. population, didn’t hold health insurance during January-March, a decline of about half a million from the same time last year, the Centers for Disease Control and Prevention said. The CDC said the change was not statistically significant.
The Affordable Care Act made big strides in its early years, adding millions of people to insurance rolls as parents were able to keep children on their plans longer, Medicaid expanded enrollment for the poor, and government subsidies and penalties helped push higher-income individuals to sign up.
But the gains have stalled in recent years as premiums rise and choices disappear.
“Generally, the [Obamacare] program covered about 20 million new people. It looks like it’s continuing to do that if the program stays in place, but there’s obviously some issues with the premiums in the exchanges that will need to be addressed long-term,” said Gary Claxton, a vice president at the nonpartisan Kaiser Family Foundation. “Some states didn’t expand Medicaid, so there’s higher rates of uninsured in those states than in states that did.”
Though Obamacare was struggling for years, Democrats say the problems have grown more acute under President Trump, who they say has sabotaged the law by threatening to withhold critical payments to insurers and pondering broad exemptions that could further upset the law’s economics.
The new CDC numbers Tuesday only included the first couple months of Mr. Trump, though, suggesting the law’s stall was in effect last year, while President Obama was in charge.
The health exchanges have struggled to attract the young, healthier customers insurers said they need to sign up in order to cover the costs for older and sicker people who jumped on board early.
Underscoring the problem, the CDC report said adults aged 25—34 were almost twice as likely as those aged 45—64 to lack health insurance coverage.
The Affordable Care Act covers roughly 10 million on its web-based insurance exchanges, where people can shop for private plans, often with the help of taxpayer-funded subsidies. And it covered millions more through the expansion of federal-state Medicaid coverage for the poor.
Yet 19 states have refused to expand Medicaid, after an early rush to grab up federal expansion dollars during Mr. Obama’s second term, and enrollment on the exchanges just saw its first year-over-year decline.
It’s unclear if more states will choose to expand their Medicaid populations or if exchange enrollment will improve when open enrollment kicks off again this fall, since the Trump administration is largely hostile to the program — even if Obamacare’s image has improved in recent polling.
Congress, meanwhile, is steeped in a fierce debate about what to do about Obamacare, after a GOP-led repeal effort stalled out in the Senate.
Mr. Trump still wants to revive efforts to repeal and replace his predecessor’s law. Yet for now, a bipartisan set of leaders in the Senate are eyeing swift action to stabilize Obamacare’s wobbly marketplace.
Senate Health Committee Chairman Lamar Alexander, Tennessee Republican, wants to fund contested Obamacare reimbursements through 2018 in exchange for giving states more freedom to offer health plans outside of the strictures set up by Mr. Obama’s law.
He has invited state insurance commissioners and governors to testify next week on reforms to the individual market, where people without job-based insurance buy private insurance on their own.
The CDC said that among adults aged 18-64, just over 70 percent had private insurance they acquired themselves or through a job, about 12 percent were uninsured and nearly 19 percent had publicly funded coverage.
People over age 65 and younger people with disabilities can qualify for Medicare, the federal insurance program that covers roughly 55 million Americans.