Newspapers, Advocacy Groups Respond to New Census Bureau Uninsurance Figures

A Census Bureau report released Sept. 30 finding that the number of uninsured people living in the United States increased last year has prompted responses from several newspapers and advocacy groups. According to the report, the number of people in the United States who lacked health coverage increased by 1.4 million in 2001, to 41.2 million, or 14.6% of the total population, compared to 39.8 million, or 14.2%, in 2000. The most significant drop in coverage rates occurred among small business workers because fewer employers are offering health benefits as they experienced budget woes and escalating health care costs. The report also found minorities continued to have above-average uninsurance rates, while the number of uninsured children was "virtually unchanged" from the previous year, largely because of growing enrollment in government-sponsored insurance programs (Kaiser Daily Health Policy Report, 9/30). The following is a summary of editorial reaction to the study:

• Boston Globe: Although the "one bit of good news" contained in the report was that government-sponsored health insurance programs have expanded access to care for low-income people, Congress should still "act this year on a proposal to send more money to the states for Medicaid and children's health programs," a Globe editorial states. As part of a proposed Medicare "giveback" bill, the Senate has included an extra $5 billion for Medicaid and CHIP programs, but the House and the Bush administration have "shown little enthusiasm" for such measures. The Globe calls on Massachusetts representatives to "press hard" for such funding, concluding, "If the states are forced to make cutbacks, next year's Census Bureau report will show that the government backtracked on the progress it had made in providing impoverished Americans with this essential coverage" (Boston Globe, 10/1).
  
• Detroit News: In light of the report's findings, Congress should ultimately "revam[p] the federal tax code to give workers tax incentives to purchase their own health coverage," a News editorial states. But given that such action is a complicated, long-term project that will require considerable political will," Congress can "take other steps" -- such putting aside money tax-free in medical savings accounts -- to provide "immediate relief." Giving MSAs to every private-sector worker would cost about $1.8 billion over five years, and the editorial concludes, "This is a small price compared with what the federal government will have to pay if it has to pick up the tab for the swelling ranks of the uninsured" (Detroit News, 10/1).
  
• Wall Street Journal: While newspapers have "play[ed] up" the Census Bureau report's findings, national media should also focus on the increasing number of federal and state health care mandates that are raising the cost of insurance, a Journal editorial states. Such mandates accounted for 15% of the increase in health spending in 2001, according to a study by PriceWaterhouseCoopers. According to HIAA, the mandates also are the "reason one in four uninsured Americans lacks coverage," the editorial notes. The Journal concludes, "The real scandal in American health insurance isn't that some people lack coverage for this or that treatment, but that tens of millions of Americans risk financial ruin because of policies that make basic insurance difficult or impossible to buy" (Wall Street Journal, 10/1).
  

Advocacy Groups Respond
The following is a summary of advocacy groups' responses to the Census Bureau report:

• Center on Budget and Policy Priorities: Noting that state governments face budget shortfalls that may force them to make cuts to Medicaid, the Center for Budget and Policy Priorities recommends in a release that Congress "prevent the further erosion of health insurance coverage by providing state fiscal relief to states through a temporary increase in the federal matching rate for Medicaid and by bolstering federal SCHIP funding" (Center for Budget and Policy Priorities release, 9/30).
  
  
• Families USA: "The increased number of uninsured Americans is a forerunner of much larger increases to come. The confluence of four factors-much higher health care costs, employers passing on more of these costs to their workers, unemployment growth, and state cutbacks in Medicaid programs-all but guarantees that the number of uninsured people will skyrocket in the next few years," Ron Pollack, Families USA executive director, said (Families USA release, 9/30).
  
  
• Health Insurance Association of America: While the report should "raise a cautionary flag to state and federal legislators," lawmakers need to "think very carefully" before passing any new regulations designed to reduce the number of uninsured, according to HIAA President Donald Young. Although such laws would likely be "well intentioned," Young states they "inevitably raise the cost of health insurance and make it more difficult for employers to continue to provide" coverage options. Young concludes, "Legislators should work to create an environment that brings affordable health insurance within the reach of millions of additional Americans" (HIAA release, 9/30).
  
• Healthcare Leadership Council: The report should "set off alarm bells" for members of Congress, who need to "take further steps to use tax incentives" to improve health care access, according to HLC President Mary Grealy. One "effective tool" for achieving such goals would be to provide all employees with refundable tax credits similar to those approved earlier this year for U.S. workers displaced by international trade. In addition, Grealy says Medicaid and CHIP programs should be improved, states need greater spending flexibility to help residents afford private health coverage and more information about the availability of health plans should be made available to small businesses (HLC release, 9/30).
  
• National Association of Manufacturers: Noting that companies "can't absorb skyrocketing health care costs indefinitely," Neil Trautwein, NAM's director of employment policy, calls on Congress to "quickly pursue" legislation that would provide workers with refundable tax credits to purchase health insurance, "encourag[e] ERISA-favored association health plans" and allow workers to roll over unused funds in flexible spending accounts. In addition, Trautwein cautions lawmakers against "adopting additional mandates" concerning employer-sponsored health coverage (NAM release, 9/30).
  
• National Center for Policy Analysis: The Census Bureau report is an "inflated estimate" of the number of uninsured people living in the United States, and Congress should be cautious about potential legislation to deal with the issue, according to NCPA. The "main problem" with the report is that respondents were asked if they had health coverage during the previous year, but "many either forget or misinterpret the question," NCPA states. In addition, many respondents who say they are uninsured are eligible for Medicaid and enroll if they become ill. Further, NCPA research indicates that the increase in the number of uninsured people is not caused by people who cannot afford health insurance but rather results from moderate- to high-income families who choose not to have health coverage. In light of the group's findings, Congress should pass "[c]arefully crafted tax credit proposals" similar to President Bush's plan rather than increase spending on government-funded insurance programs, NCPA President John Goodman states (NCPA release, 9/30).