Tuesday, March 08, 2016

Getting medical care like it's 1999

In the past year or two, job growth has returned to late-1990s levels. Wage growth has not. But thanks doubtless in large part to the ACA, access to needed medical care has also taken us back to the late Bill Clinton years, more or less.

Below is a chart of one measure of healthcare access from the latest data release of the National Health Interview Survey, including responses from January-September 2015. It's a brief history of lack of access to needed medical care in the U.S.:


Access peaked during the Clinton boom. Lack of access drifted upwards through the early 2000s, surged during the financial meltdown in 2008-2010, began dropping with ACA enactment (and sputtering economic recovery), then surged with full enactment (Medicaid expansion and marketplace launch) in 2014.

To connect this with another recent stat shot from the NHIS update: From the late nineties through the financial crisis,  lower-income workers suffered severe losses in access to employer-sponsored insurance. The ACA has helped them recoup those losses, and has in fact cut uninsurance rates among the poor (under 100% FPL)  and near-poor (100-200% FPL)  to well below late nineties levels:

Uninsurance rates for for poor and near-poor adults aged 18-64


Year
Poor
Near-poor
1997
40.2%
34.9%
2005
39.5%
36.6%
2010
42.2%
43.0%
2013
39.3%
38.5%
2015
26.1%
24.1%


 In fact gains in insurance among the poor and near-poor (together making up one third of the U.S. population) outstrip cuts in the rate of those who report going without needed care, according to the NHIS. The rate of those who go without needed care is the same as in 1997 and ll slightly higher than in 1999, while the percentage of uninsured Americans of all ages has dropped from 15.4% in 1997 to 9.1% in the first three quarters of 2015. Perhaps years of improved insurance rates will close that gap over time. But perhaps, too, a rise in under-insurance rates among those insured through their employers accounts for the slower progress on that measure.

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