Greg recently completed a research report for the Society of Actuaries entitled “Uninsured Rate” Measurements and Health Policy Considerations, available at www.soa.org/resources/research-reports/2021/uninsured-rate-measurements/. He became interested in the measurement of the uninsured rate because we don’t really know the impact of reforms on the uninsured rate, and there’s no agreed-upon definition of being uninsured despite the importance of lowering the rate of uninsurance; every significant reform from Medicare and Medicaid to the Affordable Care Act has had as a primary goal to increase the portion of Americans who are covered. Unlike with many other data elements important for healthcare, there is no file of uninsured Americans. This information must be obtained by survey. Greg’s report explains the various sources of uninsured rates. In this podcast episode we discuss the many layers of complexity to uninsured data. There are definitional issues of what counts as coverage and what length of time without coverage constitutes being uninsured. Additionally, surveys experienced considerable challenges gathering data after the pandemic started. Many important questions that are highly relevant for health policy are beyond the scope of the uninsured rates and the surveys that generate them. Questions such as why the half of uninsured Americans who are eligible for free coverage have not signed up remain unanswered.
The conversation touched on how changes implemented in the Trump and Biden administrations affected certain subsets of the uninsured and why higher income young people still find ACA Exchange plans unattractive. Greg shared his view that at this point, it’s not about affordability, but rather, whether inflated premiums and more generous subsidies result in a good value for consumers. Gayle also wonders whether the burden to taxpayers of more and more subsidies is too high.
Finally, we discussed the role of actuaries; are we thinking broadly enough and doing enough to watch out for the interests of the public? We agree that actuaries should be objective truth tellers and actuaries do have an obligation to the public; we agree that actuaries certainly should speak up about the things we know and only we know given our experience and training. Greg shared that many actuaries have told him privately that they feel restrained and can’t speak out as freely as they’d like. In today’s time of hyper-partisan hyper-polarization, actuaries are in good company in that regard; physicians, scientists, public health officials and many others also feel restrained from speaking their minds because others have been censored or canceled. Perhaps openly discussing our concerns about healthcare reform in a format like this will play a small role in encouraging others to speak openly as well.
Greg recently completed a research report for the Society of Actuaries entitled “Uninsured Rate” Measurements and Health Policy Considerations, available at www.soa.org/resources/research-reports/2021/uninsured-rate-measurements/. He became interested in the measurement of the uninsured rate because we don’t really know the impact of reforms on the uninsured rate, and there’s no agreed-upon definition of being uninsured despite the importance of lowering the rate of uninsurance; every significant reform from Medicare and Medicaid to the Affordable Care Act has had as a primary goal to increase the portion of Americans who are covered. Unlike with many other data elements important for healthcare, there is no file of uninsured Americans. This information must be obtained by survey. Greg’s report explains the various sources of uninsured rates. In this podcast episode we discuss the many layers of complexity to uninsured data. There are definitional issues of what counts as coverage and what length of time without coverage constitutes being uninsured. Additionally, surveys experienced considerable challenges gathering data after the pandemic started. Many important questions that are highly relevant for health policy are beyond the scope of the uninsured rates and the surveys that generate them. Questions such as why the half of uninsured Americans who are eligible for free coverage have not signed up remain unanswered.
The conversation touched on how changes implemented in the Trump and Biden administrations affected certain subsets of the uninsured and why higher income young people still find ACA Exchange plans unattractive. Greg shared his view that at this point, it’s not about affordability, but rather, whether inflated premiums and more generous subsidies result in a good value for consumers. Gayle also wonders whether the burden to taxpayers of more and more subsidies is too high.
Finally, we discussed the role of actuaries; are we thinking broadly enough and doing enough to watch out for the interests of the public? We agree that actuaries should be objective truth tellers and actuaries do have an obligation to the public; we agree that actuaries certainly should speak up about the things we know and only we know given our experience and training. Greg shared that many actuaries have told him privately that they feel restrained and can’t speak out as freely as they’d like. In today’s time of hyper-partisan hyper-polarization, actuaries are in good company in that regard; physicians, scientists, public health officials and many others also feel restrained from speaking their minds because others have been censored or canceled. Perhaps openly discussing our concerns about healthcare reform in a format like this will play a small role in encouraging others to speak openly as well.