By Margaret O’Hara
Increase in Uninsured
According to the U.S. Census Report released September 10, for the first time in a decade the number of Americans without health insurance has risen by about 2 million people. The report states that 8.5% of the U.S. population went without medical insurance for all of 2018, up from 7.9% in 2017. By contrast, in 2013, before the Affordable Care Act took effect, 13.3% were uninsured. The percentage of uninsured children under the age of 19 increased by 0.6 points from 2017 to 2018, rising to 5.5%.
Per NPR, Joan Alker, executive director of Georgetown University Center for Children and Families, said that the uninsured rate for kids is up sharply, and it’s due to a loss of public coverage, most commonly Medicaid. She attributed this drop to the Trump Administration making it harder for families to enroll in Medicaid coverage by curtailing outreach efforts, allowing states to ask for more paperwork, and proposing a so-called public change rule which reduces the ability of legal immigrants to get permanent resident status if they have received certain kinds of public assistance, including Medicaid.
Health Benefits of the ACA
This information comes on the heels of a report in the September 30 Washington Post that highlighted the health benefits associated with the ACA. As the Post article stated, “It is difficult to prove conclusively that the law has made a difference in people’s health, but some strong evidence has emerged in the past few years.” The evidence includes a significant increase in the detection of high blood pressure and treatment for it (according to a 2018 study in the journal Health Affairs) and fewer 19- to 25-year-olds with asthma failing to see a doctor because it cost too much (according to an analysis of survey results published earlier this year by researchers at the U.S. Centers for Disease Control and Prevention).
Most of the evidence of health benefits from the ACA comes from studies of Medicaid expansion. In the state of Michigan, to take one example, researchers have been evaluating the Healthy Michigan Plan, the Medicaid expansion that covers about 650,000 people. A 2017 study compared heart surgery patients in Michigan and Virginia, which had not yet expanded Medicaid at the time. It found that those who had cardiac bypasses or valve operations in Michigan had fewer complications afterward than similar people in Virginia, where more were uninsured. What’s more, a third of Michigan women said that, after joining Medicaid, they could more easily get birth control, and 40% of enrollees in Healthy Michigan with a chronic health condition—such as high blood pressure, a mood disorder or chronic lung disease—learned of it only after getting the coverage, according to survey results published this month.
Affordability of Prescription Drugs
Protect Our Care Illinois (POCIL), the Healthcare Coalition that includes LWVIL as a member, is turning its focus on the problem of out-of-control prescription drug costs. The state of Illinois took action in August, when Governor Pritzker signed HB 465, the first comprehensive regulation of pharmacy benefit managers (PBMs) statewide. There is still much to do, however, and a bipartisan group of legislators is working to prepare legislation to deal with this problem.
Illinois is not alone; the need to address the affordability of prescription drugs is a high priority among voters across the country, and legislation is being proposed on federal and state levels. On September 19, Nancy Pelosi and House Democrats introduced a proposal to lower drug prices through negotiations between federal health officials and the makers of some of the most expensive drugs. Learn more >>
This year 33 states have enacted a record 51 laws to address drug prices, affordability, and access. That is up from a record 45 laws enacted in 28 states set just last year, according to the National Academy for State Health Policy, a not-for-profit advocacy group that develops and promotes such laws. Learn more >>
The Reproductive Health Access Coalition, of which LWVIL is a member, advocates for legislation to improve access to a full range of reproductive health options in Illinois. The coalition is working to get SB1594, the Repeal Parental Notice for Abortion Act, out of committee. This legislation repeals the law that requires a healthcare provider to notify an adult family member at least 48 hours before performing an abortion for a patient under 18. While the majority of teens tell parents about their decision, some face barriers such as abuse, fear of homelessness, and serious family problems. LWVIL signed on as a supportive organization, advocated for passage SB1594, and continues to work with the Reproductive Health Access Coalition on this legislation.
Margaret O’Hara serves as Healthcare Specialist for the League of Women Voters of Illinois.