THE health-care-reform debate is plagued by different numbers on how many Americans lack health insurance, but we actually have excellent data on the question: Ninety percent of Americans are insured, according to the Census — and even the president more or less concurs.
The Census is the source for the much-cited figure of 46 million uninsured. Yet the very same table plainly indicates that 9 million of those are not US citizens. That leaves 37 million uninsured who are Americans.
But there’s more. In the same document, the Census also plainly states that “health-insurance coverage is underreported” in its survey. When it cross-checked its survey results with the official Medicaid rolls, it found that 16.9 percent of those on Medicaid had claimed on their Census forms that they were uninsured. That 16.9 percent amounts to 9 million people.
So the actual tally, according to the most authoritative source we have, is just 28 million uninsured citizens (46 million minus 9 million non-citizens, minus 9 million on Medicaid who were falsely recorded as uninsured).
To be more exact, it leaves 28,157,000 uninsured out of a total of 280,209,000. That leaves us with 90 percent of American citizens covered by insurance, according to the Census.
President Obama effectively agrees. In his recent speech to a joint session of Congress, he cited “more than 30 million American citizens who cannot get coverage.” In a nation of almost 300 million people, that leaves something on the order of 90 percent who can get coverage.
So, who are the 28 million uninsured? The president suggests they’re all people “who cannot get coverage.” But the Census tallies suggest otherwise.
Many of the uninsured are young. People between the ages of 18 and 34 account for only 10 percent of the population, but 18 percent of the uninsured. They are generally healthy. Except in states like New York that have made it illegal for insurance companies to offer lower rates to younger, healthier people, these Americans can get insurance cheaply — but many choose not to.
That may be problematic, but it doesn’t suggest that they “cannot get coverage.”
Then, too, the Census tells us that 47 percent of the uninsured (citizens or not) make over $50,000 a year. Since the median American family income is $50,740, this means that nearly half of those who are uninsured make more than most American families.
Indeed, more than a quarter of the uninsured (26 percent) make more than $75,000 a year — at least $24,000 more than most Americans. With a few exceptions, these folks plainly aren’t among those who “cannot get coverage.”
None of this is to deny the high costs of health care — which are often a serious burden for American families, and a key reason federal health programs are already by far the biggest contributor to the deficit. But it brings us to a simple but largely ignored truth: Only 5 percent of Americans are uninsured and making less than the median income. (And many among that 5 percent are already eligible for government programs).
For comparison, the Congressional Budget Office says that 6 percent of Americans would remain uninsured after 10 years under the bill passed by the Senate Finance Committee, which would spend nearly a trillion dollars, impose new taxes and fines of more than half a trillion and cut $400 billion-plus from Medicare and related programs — while raising taxes and spending by more than three times as much in its second decade.
Whatever course we choose, it should be based on facts, not fears. And the costs associated with health reform must be weighed against the simple fact, reported by the Census, that 90 percent of Americans are already insured — and well over half the rest can get insurance if they so choose.
Jeffrey H. Anderson, a Pacific Research Institute senior fellow, is the director of the Benjamin Rush Society.