Medicare, Medicaid Responsible for Decrease in Uninsured Rate, Not Obamacare

Single-Payer Medicare for AllThe number of people without health insurance dropped slightly in 2011 from 50 million to 48.6 million people–a decrease Democrats are eager to pounce on as proof that Obamacare is working.

“Thanks to Obamacare, the ranks of the uninsured fell this year,” writes Kevin Drum for Mother Jones Magazine.

“Attention Obamacare haters: The law you despise appears to be working,” says the New Republic.

Larry Levitt of the Kaiser Family Foundation proposes that, “The biggest decline in the ranks of the uninsured is among young adults aged 19-25. This suggests that the Affordable Care Act (ACA) provision allowing young people up to age 26 to stay on their parents’ policies is succeeding at increasing the number of people with health insurance.”.

If Larry Levitt’s theory was correct, however, then the total number of people with private insurance would have increased. But the Census Bureau tells us that, “Both the rate and number of people covered by employment-based coverage in 2011, 55.1 percent and 170.1 million, were not statistically different from 2010.”

True, private coverage among people between 19 and 25 increased by 539,000 people. 40 percent (215,600) of those people obtained coverage through their parent’s health plan. But again, the total number of people with private insurance stayed the same–meaning there is little reason to assume the ACA has had any impact yet.

So how did the number of uninsured decrease by 1.3 million people?

Simple: people are getting older and poorer. Therefore, a much stronger case can be made that already existing government programs (Medicare and Medicaid), not Obamacare, are responsible for increased health coverage.

Uninsured Totals
[Chart: Health Insurance Coverage Status and Type of Coverage by Age: 2010 and 2011 (click to enlarge)]

Unlike private insurance, “The number of people covered by government health programs increased to 99.5 million from 95.5 million.” Essentially, 2 million people were added to Medicaid (50.8 million) and 2 million people were added to Medicare (46.9 million) in 2011.

Steady poverty and unemployment resulting in decreased median income for everyone except the rich means more people are eligible for Medicaid (thus the 2 million person increase). The poverty rate remained at 15 percent, meaning 46.2 million people were living in poverty in 2011. Wages fell for the majority of Americans and inequality between the rich and poor increased. The Center on Budget and Policy Priorities explains that:

“For the 20 percent of households in the middle, average household income fell 1.7 percent, or $876. For the top 20 percent, average income rose 1.9 percent, or $3,286. For the top 5 percent of households, average income rose 5.1 percent, or $15,184. Incomes fell for the bottom four-fifths of American households, while rising only for the top fifth.”

Right now, Obamacare requires states to maintain their current eligibility levels for Medicaid (meaning they are not allowed to drop people from coverage), but all this does is maintain the status quo–it doesn’t insure new people. Income eligibility is supposed to increase to 133 percent of the federal poverty level by 2014, but the Supreme Court decision on Obamacare makes that unlikely to happen in every state. Therefore, decreased income and the steady erosion of employment-based insurance are likely the reason for increased Medicaid roles.

Medicare’s eligibility age wasn’t lowered and stayed at 65 under Obamacare so that’s not the cause for higher enrollment. According to the Washington Post, “The portion and number of Americans covered by Medicare continued to rise, as more baby boomers entered retirement age.”

Again, 4,000,000 people were added to Medicaid and Medicare (which have existed for 47 years) in 2011 while only 215,600 people were covered by the Obamacare’s young person provision (which has existed for 1 year).

It should be clear by now that major gains in health insurance coverage came from an increase in government health insurance coverage. Either way, we have a lot more work to do before we end the US healthcare crisis.

48.6 million people are currently uninsured. 48,000 people will die this year because they don’t have health insurance. Job-based insurance premiums for a family of four increased 4 percent last year and nearly doubled since 2002. This is a tragedy, not cause for celebrating Obamacare.

Even when Obamcare is fully implemented in 2014, the Congressional Budget Office estimates that 30 million people will still be uninsured. Healthcare and drug costs will continue to rapidly rise–as is happening under the Massachusetts plan from which Obamacare is modeled. And a dozen governors plan to ignore Obamacare‘s Medicaid expansion to 133% of the federal poverty rate in their states. Yet the Democrats have no plans to strengthen Obamacare.

According to the Democratic platform released at the Democratic National Convention this month, there are no calls for waivers to allow for state single-payer. There’s not even a mention of a public option. As Jon Walker of Fire Dog Lake says, “The platform of the Democratic Party is basically that the ACA is great how it is and there is very little need to improve it.”

We know it doesn’t have to be this way. With a national single-payer health program we’d cover everyone living in the US and save $500 billion a year. President Obama knows this is true and that single-payer is the solution.

Stuart Altman, President Nixon’s former health aid and advisor to Obama in the lead up to health reform recently recalled that, “Every once in awhile Obama would say, ‘Wouldn’t single-payer be simpler?’ The answer is yes. But America wasn’t ready for it.”

America is not only ready for a national, single-payer healthcare plan, it desperately needs one. Yet, despite all that Medicare and Medicaid has done to protect the most vulnerable, cuts to these programs loom no matter who wins the election next month. Those who believe in the right to healthcare should defend these programs at all costs.

Jeff Muckensturm is on the national staff of Healthcare-NOW!, a national network of single-payer advocates and organizations. Find out more about the single-payer movement at

Don’t Count on Single-Payer Comeback Without a Fight

single-payerIf the Supreme Court strikes down the Affordable Care Act (ACA), don’t worry: President Obama will push for a single-payer healthcare system. That’s the liberal spin on what could be a national embarrassment for the former constitutional law professor whose signature legislative achievement could be wiped out in June.

Again and again and again and again liberal pundits tell us that the Democrats will snap out of their centrist slumber if the Supreme Court strikes down the ACA. They’ll be radicalized and have no other choice but to turn to single-payer, so they say.

In “How Obamacare’s Rejection Would Lead to Single Payer,” Josh Barro writes: “SCOTUS striking down the law would also be likely to radicalize Democrats on the health issue… Rejection of Obamacare would likely lead to support for more radical policies among the liberal base and Democratic officeholders. They’ll be mad, and they’ll want to fight back.”

And “…with a bit of political jujitsu,” says Robert Reich, “the President could turn any such defeat into a victory for a single-payer healthcare system – Medicare for all.”

If only. But this line of thinking simply doesn’t fit President Obama’s history of consistently caving to the right for fear of being labeled a far-left socialist. In 2008 the Republicans wouldn’t bite on the public option. So, despite having a Democratic majority in the House and Senate, he moved to the right and supported the individual mandate (something he vehemently opposed before the 2008 election) and still didn’t get one Republican vote.

Those of us supporting a single-payer system must not be fooled by this argument. Winning national single-payer healthcare, no matter what the Supreme Court rules this summer, will be a battle fought tooth and nail against the for-profit health insurance corporations, the American Medical Association, and Big Pharma. It won’t simply be handed to us by President Obama or the Democratic party.

Same goes with the Employee Free Choice Act (dead), or closing Guantanamo (still open), or nixing the Keystone XL pipeline (we’ll build half of it), or ending the war in Iraq (18,000 troops still on the ground).

President Obama is a center-right leader, and we shouldn’t expect anything else.

Historical experience shows that a political defeat for the Obama administration won’t herald a radical shift to the left on healthcare policy. After Clinton lost his health reform battle (not even getting his bill out of committee in 1994) did he take a strong stance on single-payer–even though the single-payer bill in the House at that time had more co-sponsors than his own bill did? No. Instead, all we got was the State Children’s Health Insurance Program (SCHIP), which only covers about half of American children (Geyman, 226). A positive step, to be sure, but far short of an embrace of single-payer.

The overall message here is “do nothing.” Obama’s got this. Just get out and vote for him in November and everything will be fine. Don’t get mad at him and certainly don’t stay home on Election Day.

Don’t fall for it.

The Supreme Court’s decision won’t radicalize the Democrats or the President. Single-payer won’t be their only option. If the ACA goes down Obama will most likely drop the healthcare issue altogether or, less likely, rebrand the public option.

When liberal pundits say Medicare-for-all, they mean Medicare for all to buy–AKA a public option to compete in the market with private insurance. We know the public option won’t reduce costs or be universal or be equitable. Health Care for America Now, the $40 million health reform group, that supposedly backed a public option, and openly campaigned against single-payer, won’t come around so easily either. They’re busy trying to save face by backing Democrats and defending the individual mandate.

We want a truly universal single-payer healthcare system in which everyone in the US, undocumented immigrants included, have access to comprehensive coverage. A system with full women’s health benefits included. A system without copays or deductibles. Without for-profit hospitals, and without private insurance in the mix. As we know too well, the Democrats are quick to use women’s and immigrants’ health as a bargaining chip. We must not allow that.

It’s our job to continue to remind Congress and the President that there is an alternative to the status-quo. It will take a lot more marching, educating, and protesting before they hear us.

So we better keep organizing.

Jeff Muckensturm is on the national staff of Healthcare-NOW!, a national network of single-payer advocates and organizations. Find out more about the single-payer movement at or follow Healthcare-NOW! on Facebook and Twitter.

Austerity in America: The Fall of Camden, NJ

Monday, May 16th – 7pm
The A-Space, 4722 Baltimore Ave., Philadelphia, PA

Camden, New Jersey went from a diverse and mighty industrial city–home to 55,000 of good paying industrial jobs–only to become the one of the nationʼs most segregated and poorest

In 2002, the New Jersey state government claimed it needed to take over nearly all of the cityʼs functions–legally disenfranchising every resident–only to leave a trail of failed development schemes and enough financial ruin that the city recently laid off half of its police and fire departments.

Join us for an intriguing discussion about capital flight, severe austerity, urban development, and political corruption.

Panelists include:
Dr. Howard Gillette – Professor of History at Rutgers University-Camden and author of Camden After the Fall: Decline and Renewal in a Post-Industrial City.
Tom Knoche – Community organizer, Camden activist, and author of Common Sense for Camden: Taking Back Our City.
Dan Sidorick – Adjunct Assistant Professor of History at Temple University and author of Condensed Capitalism: Campbell Soup and the Pursuit of Cheap Production in the Twentieth Century.

Part of the Philadelphia Industrial Workers of the World’s Philly Labor Talk Series.
Contact with questions. This event is FREE!