Posted on September 18, 2019

Rise in Health Uninsured Linked to Immigrants’ Fears

Associated Press, September 16, 2019

When the Census Bureau reported an increase in the number of people without health insurance in America, it sent political partisans reaching for talking points on the Obama-era health law and its travails. But new numbers suggest that fears of the Trump administration’s immigration crackdown may be a more significant factor.

The number of uninsured in the United States rose by 1.9 million people in 2018, the agency report last week. It was the first jump in nearly a decade. {snip}

The report showed that a drop in low-income people enrolled in Medicaid was the most significant factor behind the higher number of uninsured people.

Latino were the only major racial and ethnic category with a significant increase in uninsured rate. It rose by 1.6% in 2018, with nearly 18% lacking coverage.

There was no significant change in health insurance for non-Latino whites, blacks and Asians.


The administration issued a statement blaming the law’s high premiums, unaffordable for solid middle-class people who do not qualify for financial assistance. “The reality is we will continue to see the number of uninsured increase until we address the underlying issues in Obamacare that have failed the American people,” the statement said.


Health economist Richard Frank of Harvard Medical School said the data “suggest that we are dealing with immigration … potentially in some unexpected ways.” Frank was a high-ranking health policy adviser in the Obama administration.

The uninsured rate for foreign-born people, including those who have become U.S. citizens, also rose significantly, mirroring the shift among Latinos.

Frank noted that immigrant families often include foreign-born and native-born relatives, “and you can imagine the new approach to immigration inhibiting these people from doing things that would make them more visible to public authorities,” such as applying for government health care programs.

Immigrants’ fears may also be part of the reason for a significant increase in the number of uninsured children in 2018, {snip}. The increase was greater among children who are not citizens.


— The report found a statistically significant increase in middle-class people who are uninsured. Health care researcher and consultant Brian Blase, who until recently was a White House adviser, said it appears to reflect people who cannot afford high ACA premiums. {snip}

— Experts are debating the impact of a strong job market on the decline in Medicaid enrollment. It’s possible that some Medicaid recipients took jobs that boosted their earnings, making them ineligible for benefits. But if those jobs did not provide health benefits, then the workers would become uninsured. {snip}