Ornery Facts

As we work to cover the uninsured, a goal all Americans share, it is key to understand who they are.  Otherwise we will change the law but not achieve the goal. Let’s accurately identify who really needs a new program to provide coverage.

20% are eligible for government programs but are not enrolled. That is almost 10 million people who don’t need a new program; what they need is better outreach by existing programs. Add to that the 19%, or 9 million, that earn more than $75,000. (close to 400% of the FPL for a family of 4) and the 13%, or 6 million, that are eligible for employer coverage (only 5% of whom go uninsured). They don’t really need a new program either. Then there are the 22% who are ineligible because they are here illegally or are in their first five years of legal residence.  That’s 12 million who DO need some type of coverage. So you get some idea of the impossibility of measuring success by “47 million”.

Success in covering those we think of as the uninsured is within our grasp. We must find a way for the 12 million citizens who are not eligible for government or employer plans and who earn less than $75,000 a year to have access to a variety of health plans. Most of these folks work in small businesses and earn low wages.  Premium subsidies will be required to make plans affordable, even 100% subsidies for those leaving Medicaid.  And we need to assure that for those currently uninsured but eligible for existing coverage outreach and funding exist so they participate fully.

This is a realistic goal and would be a huge victory!  The good news: both Presidential candidates agree on this much.  The bad news: the details are hard. Only a thoughtful bipartisan effort can achieve the goal, and in the same bill, control cost growth so that health care will be affordable to those that have it as well as to the newcomers.

Realistic goals will reward the hard work of accomplishing real and significant reform. Equally important, it will avoid the cycle of failure that dishonors government and the generosity of our people.

This entry was posted on Saturday, October 11th, 2008 at 8:56 am and is filed under Coverage Policy, Insurance. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.