Obamacare: Pain but No Gain in Driving Down Uninsured

President Obama in a speech to Congress in September 2009, stated that the central goal of the Accountable Care Act (aka Obamacare), is extending health care coverage to the "…more than 30 million American citizens who cannot get coverage." Yet here we are less than two weeks away from the end of open enrollment and the number of Americans who lack insurance is still 30 million. A 'back of the envelope' estimate helps make the point. Although the math cannot be precise, the underlying logic is difficult to refute.

Modern Healthcare reported a total of 48 million uninsured at the beginning of the Obamacare roll-out in October 2013.

Relying on statistics from the Kaiser Family Foundation, it is reasonable to assume 80 percent of these 48 million are U.S. citizens, eligible for health care coverage under the Federal law. This indicates that the magnitude of the uninsured grew from 30 million U.S. citizens in 2009 to 39 million U.S. citizens in 2013 – a more than 25% increase in the time leading up to open enrollment.

This growth in the uninsured was largely the product of an economy that only created 1.4 million new jobs (U.S. Bureau of Labor Statistics) for more than 8 million new Americans seeking work, accounting for nearly 7 million of the 9 million new uninsured emerging during that time.

So, nearly seven months after official roll out of the Law, how far has Obamacare come in reducing the ranks of the uninsured?

It is estimated that nearly 3 million individuals have signed up for Medicaid for the first time following implementation of the ACA.  Let's assume that all of these individuals gained coverage because of the newly expanded Medicaid Program although it is likely that some were eligible for the program prior to the expansion. This suggests the Law has reduced the number of uninsured Americans to 36 million as a result of this one provision.

Another 4 million Americans have signed up for private health coverage on the new exchanges. Under a 'best case' scenario it is estimated this number could reach 6 million by the end of the open enrollment period at the end of this month. This would bring the total number of uninsured down once again to 30 million.

We know that the 5 to 6 million citizens with individual plans were canceled under Obamacare because they did not meet minimum coverage requirements dictated by the Law. However, to be conservative for this analysis we've assumed that all of the individuals affected by that change have regained coverage through their insurers. Therefore, their cancellations are presumed to have not ultimately changed the number of uninsured.

So, despite all of the new regulations, taxes and mandates brought on by Obamacare, there remain 30 million uninsured Americans. We have ended up right back where we started only more in debt and uncertain of what lies ahead.