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Another View

How to think about health coverage

The number of Americans without health insurance rose last year, the Census Bureau reported Tuesday, and Democrats say this justifies more government control. Yet the reality is more complicated – in particular, note that having a Medicaid card is no guarantee of great medical care.

The good Census news is that real median earnings of men and women who work full time and year-round “increased by 3.4% and 3.3%, respectively, between 2017 and 2018.” Some 2.3 million more Americans are working full time. The poverty rate fell 0.5 percentage points from 2017, to 11.8%, the fourth decline in a row.

Yet 8.5% of Americans lacked health insurance in 2018, up from 7.9% in 2017, the first increase since the recession, and this figure is getting all the media attention. Much of the decline comes from a dip in Medicaid coverage, and as a general rule you’d expect fewer folks to qualify for Medicaid as the economy improves and poverty declines.

But Census notes that overall coverage fell one percentage point for people in families that earn 300% to 399% of the federal poverty line, and 0.8 percentage points for folks above 400%. “During this time,” Census notes, the insurance coverage rate “did not statistically change for any other income-to-poverty group.”

These are the folks we’ve written about many times: Americans who earn too much to qualify for ObamaCare subsidies. The left’s solution is to reinstate the individual mandate that forces the middle class to buy the product anyway. This shows that merely having access to insurance doesn’t mean it’s valued.

The left is blaming the higher uninsured rate on Trump Administration policies, including its rules on association health plans and short-term insurance options. But the point of association health plans is to make it easier for small businesses to offer insurance.

The left is also flogging that uninsured rates are lower in states that expanded Medicaid under the Affordable Care Act than in those that didn’t. This is presented as a reason to expand Medicaid.

The larger point is that the only conversation the left wants to have about health care is how many Americans are insured, and that’s so they don’t have to answer for failures like Medicaid’s narrow provider networks, high emergency room use rates, and more.

Democrats running for President talk about proposals like Medicare for All exclusively as “universal coverage,” not about, say, how quickly you’ll be able to see a specialist. Having that insurance card in your wallet will be small consolation as you wait for a knee replacement allocated by political discretion.

The Wall Street Journal

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