Now that PPACA directives are reality and health insurance exchanges are in place, just what impact will health care reform really have on the number of uninsured Americans?
Circumstances or Choice?
With projections over the years having been as high as 45 million, the reality is that about 75% of uninsured were without coverage voluntarily. Who are these uninsured and why are they without coverage when they can afford it?
- The largest group is actually insured, but lost coverage for a short period of time, such as with a job change – making counts misleading.
- Next are those who discovered it is cheaper to be uninsured – getting free care with no deductible or co-pay.
- Many young and healthy believe health care premiums cost more than they will ever spend on medical treatment.
- Numerous early retirees and laid-off executives elect to coast without coverage until Medicare eligibility.
- A large number of homeless and mentally unstable are eligible for coverage through Veterans, Medicaid, Medicare or state/local programs, but had a bad experience or distrust government.
Some say the number of uninsured will increase over the next few years as enforcement of employer mandates drives declines in employer-sponsored coverage. No matter the numbers, once you subtract the tens of millions of voluntarily uninsured, those that remain could have been given lifetime care for a tiny fraction of the cost of reform.
In cooperation with NAEBA