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The Number of Uninsured is Crucial to the Discussion

Boston Globe
August 06, 2009

It’s a central goal of President Obama’s plan: extending healthcare coverage to the millions of Americans who lack it.

But the question is: Just how many are really uninsured? The answer could make a huge difference in the billions of dollars it will cost to remake the national system.

Obama frequently cites last year’s Census Bureau number of 46 million people with no health insurance. Some specialists, however, argue that figure is off by tens of millions.

The recession’s continuing toll on jobs, a tendency to undercount people on Medicaid, and other factors make it hard to come up with an exact number. And the most widely accepted range – 40 million to 50 million – includes some 10 million noncitizens, a detail that’s generally overlooked.

The lack of certainty about such big numbers is one more question mark for Obama and members of Congress as they try to craft a plan that would cover most of the uninsured. Obama says his goal is to cover 97 percent to 98 percent of Americans, a target that would be reached by plans taking shape in the Senate – if you don’t count illegal immigrants. A bill crafted by House Democrats comes in closer to 94 percent.

All the plans would exclude illegal immigrants, who account for as much as 17 percent of the uninsured, according to the Pew Hispanic Center.

New Census Bureau figures expected to be released on Sept. 10 could scramble the equation, adding billions in costs if the numbers come in higher than expected, or reducing costs if the numbers are lower.

There could be serious implications “if we all of a sudden found that instead of 45 million uninsured there are 35 million,” said Michael O’Grady, a senior fellow at the University of Chicago’s health policy and evaluation department and a former assistant secretary at the Department of Health and Human Services.

A lower figure could cut two ways: making Congress’s job cheaper, but also making the country’s healthcare woes seem less pressing.


August 6, 2009 - Posted by | Federal Government, healthcare | , , ,

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