Are There Really 47 Million Americans Who Can't Afford Health Insurance?

An editorial in the July-August 2009 AARP Bulletin repeats the same bromide heard almost nightly on the MSM news: That there are currently 47 million Americans without health insurance. The AARP editorial goes on to argue that this situation is disgraceful; that all Americans should have "affordable health care choices"; and that in terms of reform, "the time to act is now."

The sad tale of the 47 million uninsured is, perhaps, the most emotionally persuasive argument put forth for national health care reform. But is the alleged number of uninsured reasonably accurate? Or is it, instead, a purposely misleading statistic designed to advance a specific reform agenda?

The 47 million uninsured number is generated by an annual U.S. Census Bureau report. However, that report also states that the 47 million uninsured includes roughly 10 million illegal aliens without health insurance. Thus, if we subtract out the illegals, the number of uninsured American citizens without health insurance declines by more than 20%…to roughly 37 million.

But is it accurate to assume that even 37 million Americans cannot afford health insurance? Absolutely NOT. Even Hillary Clinton during her presidential campaign once admitted that 25% of the uninsured could afford health insurance but chose not to purchase it. The Census Bureau reports that there are roughly 17 million people who make more than $50,000 per year and who, for whatever reason, decide not to carry health insurance.

  $22     $20       In short, with two reasonable adjustments, the number of Americans who cannot afford health insurance has been reduced from 47 million to approximately 20 million.

But is the 20 million figure itself reasonably accurate? Probably not. Individuals moving between jobs lose their (employer provided) health insurance and when they do the Census Bureau counts them as "uninsured." Technically true. Yet during normal times, roughly half of these individuals will have re-acquired (in about 4 months) health insurance coverage with a new employer.

Finally, there are millions of adult Americans and children who have (nearly free) access to medical care benefits through Medicaid and other government programs who don’t really need the direct cost of "insurance" and who don’t carry any.

    $15     $10     Thus, with reasonable adjustments, there are in fact less than 10 million individuals who are so-called "chronically uninsured." (The Kaiser Family Foundation says the number could be as low as 8 million). These are individuals who have been unemployed for over 2 years and/or people from households that are too poor to afford non-employer health insurance premiums and who, for whatever reason, have limited access to taxpayer-supported health services.

So let’s grant that there are between 8 to 10 million Americans (total population: 307 million) who cannot afford health insurance and that this situation may require a marginal public policy adjustment. (Most states mandate expensive benefit coverage; curtailing those mandates would lower the cost of health insurance.) But whether that situation requires some massive, Washington D.C. health care reform — with new regulations and mandates on health care providers, insurance companies, and drug manufacturers — is entirely problematic.

Politicians and interest groups, eager to remake your medical world over to their liking, would do well to respect the Hippocratic oath administered to physicians: “First, do no harm.”