There is all kind of left- and right-wing propaganda floating around in late 2014 that claims to capture the percentage of "uninsured Americans1" before and after the 2010 passage of the Patient Protection and Affordable Care Act (PPACA, better known as Obamacare). Much of the coverage also compares the numbers to the poor to failed initial 2013 attempt by the Federal and some state governments to become insurance brokers (known as the "Obamacare exchanges"). To the extent these statistics include Massachusetts, the national numbers are quite misleading.
- Massachusetts exchange basically never worked in 2013 so any comparision with last year is ludicrous
- Massachusetts is entering the 30th year of "guaranteed coverage2" of most health care costs for 100% of its citizens, the 30th year since the 1985 passage in Massachusetts of the "free care" tax on our health-care insurance policies and hospital stays, a tax that heavily supported community health centers and their pharmacies and also compensated acute care hospitals for Massachusetts always relatively low percentage of uncompensated care.
The late 2014 news coverage of the Massachusetts "uninsured" numbers are especially strange because these numbers will actually go down in 2015 by definition.
It's simple math: Massachusetts healthcare statisticians currently claim that in 2014 we have more people with "healthcare insurance3" than we have people. (In 2014, because we effectively had no exchange, everyone that applied got Medicaid no questions asked so many people ended up with multiple coverages.)
- A useful comparison would be with the last full year before RomneyCare was repealed, 2011
- Another possibility would be to compare 2015 with the last full year, 2004, before RomneyCare was proposed.
- The most useful comparison is with 1995 both because it covers a generation of failed so-called health reforms in Massachusetts (there have been about a dozen so-called "Massachusetts health care reform laws" since the 1985 creation of the free care tax) and because 1995 was the year before guaranteed issue (often incorrectly attributed to RomneyCare) was proposed (and shortly thereafter passed4), and back when we had an individual market for healthcare insurance in Massachusetts.
In a 1995-2015 comparsion one would find that 100% of the people were covered in 1995 and 100% are covered now. What is all the propaganda trying to prove?
1Be careful because a lot of the propaganda includes people who live in the United States -- legally or illegally -- but are not United States citizens. Including these two groups seriously screws the statistics
2The total coverage is theoretical, like full employment statistics. There are always people between jobs who are without coverage for a month or two and there is always a small group of people who would rather not have insurance at all (so much so that they willingly pay the state a tax instead of finding a policy) and there are always poor people totally qualified for Medicaid3 who fall through the cracks.
3They consider Medicaid insurance; I doubt if anyone who is on Medicaid thinks of it as insurance
4Massachusetts was not the first state with guaranteed issue when that law passed in the last 1990s. That's one of many Gruberisms floating around about RomneyCare. We were sixth or seventh.