The new census report may be restating the obvious: the recession hit, poverty spikes--what did you expect? But the last part presents one of the corollary impacts of economic devastation: a battered and bruised health care system. According to the Census Bureau:
The number of people covered by private health insurance decreased to 194.5 million in 2009 from 201.0 million in 2008. The number of people covered by government health insurance increased to 93.2 million in 2009 from 87.4 million in 2008.
Kaiser Health News reports that government-run medical programs have absorbed much of the fallout:
While the numbers of people on Medicare remains stable, the percentage of people covered by Medicaid, the federal-state program for people with low incomes, rose from to 15.7 percent of Americans from 14.1 percent. Nearly 48 million Americans are in Medicaid programs.
With an uninsured rate of about 20 percent, adult women are in an especially precarious position, straddling an eroding private insurance system as well as an overstretched safety net, according to the National Women's Law Center:
Last year, over 6.5 million fewer people had job-based coverage. The proportion of women ages 18-64 with this type of insurance fell from 64 percent to 61 percent from 2008 to 2009. Public health insurance programs, like Medicaid, provided a safety-net for many women (an additional 1.2 million women had public health insurance in 2009); without these critical programs, women's uninsured rates would be considerably worse.
But the growth in Medicaid coverage has not offset the drop-off in employer-sponsored coverage, which, for all its outrageous costs, remains a pillar of the system. The new healthcare reform plan is supposed to help expand Medicaid coverage, but those changes won't go into effect until 2014. In the meantime, the Economic Policy Institute points out that we should brace ourselves for an escalating crisis as employer-sponsored coverage falls another half-percentage point by 2011. Overall, we can expect another half million non-elderly people to join the ranks of the uninsured. On top of that, there was major increase in the uninsured rate among people with household incomes of $50,000 or more, which means many uninsured "middle class" households could end up with nothing to fall back on except the new private insurance exchanges, which will leave their coverage at the mercy of corporate profit motives. As we've reported before, the exchanges might deepen racial and gender imbalances in healthcare access, freighted with crippling costs as well as harsh restrictions on reproductive health services. In addition to the poor, near-poor and people of color, another group left behind are millions of immigrants, who are subject to discriminatory federal restrictions or, if they're undocumented, are completely excluded from the system. The rise in the uninsured rate was steeper for non-citizens than for the native-born:
Among the foreign-born population, the uninsured rate increased for noncitizens in 2009 to 46.0 percent from 44.7 percent in 2008... The proportion of the foreign-born population without health insurance in 2009 was nearly two and one-half times that of the native-born population in 2009.
Obama, making his pre-election rounds in the Beltway, nonetheless keeps pushing health reform as a victory for Latinos (perhaps to take the sting off the utter failure of immigration reform). So it goes. When it comes to who has the right to be healthy in this country, what's stunning about the census numbers is not what has changed, but how patterns of inequity have become even more entrenched and so many lawmakers remain numb to the crisis (or even push to " repeal and replace"). Maybe with another few hundred thousand newly uninsured people next year, Washington will finally figure out that ignoring the pain won't make it go away.