August 26, 2008—Today, the Census Bureau released the latest data on the number of Americans without health insurance. The number of uninsured individuals fell to 45.7 million in 2007 from 47.0 million in 2006. This decline of 1.3 million uninsured people was exactly equal to the growth in coverage under Medicaid. In contrast, employment-based coverage declined slightly, from 59.7 percent of the population to 59.3 percent—despite a growth in real median income.
Today's data release shows the importance of the nation's safety net insurance system—Medicaid and the State Children's Health Insurance Program (SCHIP). The major bright spot in these new data was an increase in coverage for children, with the numbers of uninsured children declining from 8.7 million to 8.1 million, from 11.7 percent to 11.0 percent. This improvement was a reflection of increased coverage for children under government health insurance programs, which rose from 29.8 percent in 2006 to 31.0 percent in 2007. The uninsured rate for children living in poverty decreased to 17.6 percent from 19.3 percent in 2006. However, more than 8 million children remain uninsured, which highlights the importance of permanent reauthorization of the SCHIP program and adequate funding to cover all low-income children.
States have also played an important role in stepping up to the plate to address the issue of the uninsured. Massachusetts, which enacted health reform in April 2006, has moved into first place with the lowest uninsured rates. In Massachusetts, 7.9 percent of the population was uninsured in 2006–2007, compared with 24.8 percent in Texas, the state with the highest uninsured rate. A recent report from the Massachusetts Commonwealth Connector indicates that 439,000 people have obtained coverage under the Massachusetts health insurance reforms.
An uninsured population of 45.7 million Americans is staggering. This means that millions of people do not have access to needed health care, struggle under a load of medical debt, and all too often must choose between medical care and other essentials, like food or housing. A recent study by The Commonwealth Fund found that 79 million Americans have problems paying medical bills or are paying off accumulated medical debt. Nobody should face bankruptcy or the loss of their home as a result of a serious illness.
Americans are calling on the presidential candidates to fix our fragmented, inefficient health care system. In a recent survey conducted for The Commonwealth Fund Commission on a High Performance Health System, 82 percent of Americans said our health system should be fundamentally changed or completely rebuilt, and one-third said they had experienced unnecessary or inefficient care. We must do better with the substantial resources we spend on health care--over $7,000 per capita in 2006, more than twice as much as any other nation.
Universal coverage is a necessary first step. To achieve a truly high performance health care system, the new President and Congress must also take action to:
- extend affordable health insurance to all;
- change the way we pay for care to reward hospitals and physicians for providing high-quality, high-value care;
- organize the health care system to ensure that every patient has a medical home that provides accessible and coordinated care, and ensure that all patients receive the preventive care and chronic disease care that help them live healthy lives;
- meet and raise benchmarks for high-quality, efficient care by investing in health information technology, information systems, and research on the effectiveness of care; and
- provide national leadership to mobilize all parts of the health system to achieve a high performance health system.
In 2009 we need bold action on the part of policymakers and health care leaders to ensure that all Americans have access to the best health care. Our nation's future health and prosperity depends on it.