Reasons for Being Uninsured Among Adults Aged 18–64 in the United States, 2019

Products - Data Briefs - Number 382 - September 2020

Comment by Don McCanne



This report is important because it shows how well (or not) our health care financing system was working under full implementation of the Affordable Care Act but before the onset of the COVID-19 pandemic. It demonstrates that 14.5% of adults under age 65 were uninsured, and the primary reason was the fact that health insurance coverage was not affordable.



This confirms that the current health care financing system is not functioning satisfactorily, so intervention is an imperative.



What choices do we have?



*  Maintain the status quo. No politician supports this, and they shouldn't because it would perpetuate personal financial hardship, physical suffering and premature death.



*  Continue to implement President Trump's largely random policies designed to reduce government spending and regulation. The numbers of uninsured will continue to increase and actual health care will continue to be less and less affordable. Financial hardship, suffering and death would increase. Not acceptable.



*  Enact and implement Joe Biden's proposals for reform that would tweak the current system, leaving in place the Affordable Care Act and possibly adding a public option. Health care spending would increase, the burden of our profound administrative waste would increase, and many would still be left without adequate coverage. It would fail to achieve the goals of universality, affordability and administrative efficiency. We can do better, much better.



*  Enact and implement a well designed, single payer, improved Medicare for All. Coverage for all essential health care services would include absolutely everyone. Since it is funded through equitable progressive taxes, it would be affordable for each of us. The current administrative waste would be largely recovered, returning to society enough funds to pay, through equitable taxes, for the additional care required by those currently uninsured or underinsured. Universal, affordable, equitable, efficient - meeting all of our goals in a system we can afford.



We do need gifted leadership to move forward. Unfortunately that leadership was difficult to identify in last night's presidential debate. It's clear the current team has failed us. So do we take our chances on a new team that has already rejected the single payer Medicare for All model? Or might their political position be malleable?