Let’s break down the enrollment numbers on America’s healthcare and where folks get their coverage. You’ll be surprised!

In previous Posts we have discussed how the media headlines are often misleading if not downright wrong and one may wonder how often intentionally. Your humble author has repeatedly pointed out the confusing and misleading articles that refer to premium increases, access to care, unit costs of care, individual vs. employer sponsored plans as well as Medicaid to name a few.

Let’s look at the numbers for how we Americans are covered. We will look at the coverage numbers for ER-employer sponsored, NG– non-group, Mcaid-Medicaid, Mcare-Medicare, OPub-other public coverage and Unins-uninsured. Plus, we’ll see the change from 2013 to 2016 which will support many of the statements we’ve made in the past.

Statistics for the United States:
Coverage     2013           2016                Difference

Pop    313,401,200      320,372,000        6,970,800

ER      155,696,900      157,381,500        1,684,600
NG       13,816,000        21,884,400        8,068,400
MCaid   54,919,100        62,303,400        7,384,300
Mcare   40,876,300        44,550,200        3,673,900
O Pub     6,295,400        6,192,200         – 103,200
Unins   41,795,100        28,051,900     -13,743,200

As I study these numbers a few things stick out like a skunk at the Rose Parade.

  • Employer sponsored plans at 157 million, cover half of all Americans. Actually, I think the percentage is higher than the report suggests.
    Can you imagine the confusion and the anger and the mess if a single payer plan forced 157 million of us on to a Medicare for all plan? It would be worse that the roll out of the ACA was, is and will be if not corrected.
  • The overall population increased by 7 million while the employer sponsored and non-group increased by almost 10 million. That means responsible Americans and employer sponsored plans picked up a big part of that increase.
  • The uninsured population is still a huge number. The ACA proponents use talking points like no pre-existing conditions, open access and only 9% etc but the fact is 28 million is a darn big number. Plus, with premiums as high as they are it’s likely we won’t see a better percentage covered.
  • Medicaid grew dramatically which is due to what’s called Medicare expansion. Remember, these folks reported low income levels which honestly can not afford the premium cost of individual plans. All of those 7.3 million folks are having their benefits (premium and claims) paid by the faithful American tax-payer.
  • Medicaid recipients involve 50% more people covered than Medicare. Remember that Medicaid is primarily healthy-under age-65 working age citizens. Disabled American’s would be under Medicare so the Medicaid population is a number that should concern us all, plus it’s what the Medicare for all folks will push.

Now, you can see what we mean when we point out the biased misleading press about the impact of premium increases to the ACA “public plans”. The non-group population is 22 million of which roughly 10 million people are enrolled in the public exchanges. That’s less than 3% of our national population are enrolled  in the exchanges yet the ACA proponents use those plans when they shape their message to the uninformed. Not cool!

We should not forget that 85-90% of the folks covered by the public plans have their premium as well as their plan’s out of pocket paid for them. That means these folks are not effected by premium increases. I remind you of that fact not for critique but as reminder that when the press speaks and writes of the premium increases it seldom points out that these folks are not affected.

Let’s give the employer sponsored group a hearty “well done”. Employers generally sponsor plans that are richer that the individual plans, provide better access to providers, have been guarantee issue with no pre-ex if covered before for years, and pay for the majority of the premium.

When employers implement court-case tested HRAs then benefits are vastly improved over the standard metallic plans we all hate. BTW, California has and will continue to see the advantage of TPA administered HRAs thanks to the Court ordered injunction secured in one TPA’s anti-trust suit against a major insurer. All employers can now implement an HRA program without restriction of fear of insurer backlash. Again, thank you to the TPA who settled this for us all. But I digress!

I initially planned to include the numbers for California in the above chart. But, it would only irritate out of state readers because California enrollments are a huge percentage of the national numbers. That would tick me off if I lived in a state other than California.

With mid-term election just around the corner we will hear endless diatribes about the value of Medicare for All otherwise known as Single-payer. Don’t fall victim to misinformation as candidates make promises that they know they can’t keep. Remember “if you like your doctor you can keep your doctor” so that you don’t get pulled into the confusion.

The Congress will be back in session in a couple weeks and with mid-term elections only weeks away expect to hear a lot of “Cr*p” that will never get a word said after the election, regardless of outcome.

We’ll keep an eye and ear on it so that we don’t get fooled again. When we’re properly informed they will realize that we’re all in this together.

Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf

 

 

 

 

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