Statement from Commonwealth Fund President Karen Davis: New Census Data on Uninsured Shows Recession Hits Middle-Class Health Care Coverage Hard

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New York, NY, September 16, 2010—Today the U.S. Census Bureau released the latest data on the number of Americans without health insurance. The number rose to 50.7 million in 2009, from 46.3 million in 2008, the highest level since the Census Bureau began collecting this data in 1987. Reflecting the nation's high unemployment rate, the record increase in the numbers of people who lack health coverage was driven by a dramatic drop-off in private insurance, especially in employer-sponsored insurance.

Last year, nearly 7 million people lost coverage they had previously obtained through an employer. These numbers illustrate the harsh toll the recession has taken on millions of Americans' access to health care and highlight the urgent need for those provisions of the Affordable Care Act (ACA) designed to provide middle-class families with affordable options if they lose coverage through their jobs.

The major provisions of the law that take effect in 2014 will bring sweeping change to insurance coverage for many Americans, ensuring that future economic recessions do not jeopardize the health security and access to care of working families. The Congressional Budget Office estimates that the law's expansion in Medicaid coverage and subsidized private health insurance through new insurance exchanges and other provisions will cover at least 32 million who are uninsured by 2019—reversing this upward climb in the numbers of Americans without coverage.

This loss of health insurance affects Americans of all incomes, and is having a substantial impact on the middle class. Of the 4.3 million increase in the number of uninsured, half have incomes over $50,000. Government programs, including Medicaid and the Children's Health Insurance Program, played a critical role in stemming the overall losses, covering 5 million more people, more than half of them children, and helping to keep many low-income families and children covered. But middle-class families need immediate assistance.

Fortunately, while many provisions of the new law don't take effect until 2014, several, beginning next week on September 23rd, stand to give millions of Americans access to more stable and secure health insurance this year, providing important transitional relief for families particularly at risk of lacking insurance. A recent Commonwealth Fund report found that among those who will be helped right away are:

  • 102 million people who currently have lifetime limits on their health insurance and 18 million who have annual limits. Under the ACA, insurers face restrictions on placing such limits on policyholders.
  • 1 million young adults who could gain coverage under the law, by remaining on or joining their parents' policies until they are 26 years old.
  • 10,700 people who are estimated to have their coverage rescinded—or retroactively cancelled—each year. Rescissions are no longer allowed.
  • 200,000–400,000 people with preexisting health conditions who will immediately be able to enroll in special preexisting condition insurance plans.
  • Thousands of children with preexisting conditions who can no longer be denied health insurance.

A separate Commonwealth Fund report examining how small businesses will be affected by health reform found that 16.6 million people work in businesses that are eligible for the tax cuts the ACA provides to small employers that offer their employees health insurance and pay at least half the premium. The tax cuts, which represent the first direct subsidies paid to any group under the ACA, will apply to the entire 2010 tax year.

But the record losses in coverage experienced by millions of middle-income families point to the need to accelerate implementation of health reform to provide faster relief to people who lose their employer coverage. Federal assistance to states to expand eligibility in Medicaid for adults, COBRA premium assistance for the unemployed, premium assistance for middle-income Americans, and earlier implementation of the health insurance exchanges with premium subsidies for middle-income families are all important steps worthy of action. This is not the time to be talking about repealing health reform. It is urgently needed and should be accelerated. The nation cannot afford to ignore the plight of millions of Americans whose health is at risk, and whose health and productivity are key to revitalizing the American economy.

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Publication Date:
September 16, 2010