A letter to the editor over the weekend accuses me of being factually inaccurate in a recent post which pointed out that Obamacare hasn’t made health insurance cheaper and hasn’t, for North Dakota, improved the uninsured rates.
It’s an important topic, because Democrats like Senator Heidi Heitkamp are campaigning on the idea that Republicans want to undo the good Obamacare has wrought while Republicans counter that Obamacare hasn’t done us much good in the first place.
“Rob Port’s recent blog post concerning the Affordable Care Act, ‘Obamacare didn’t improve the uninsured problem and it didn’t make insurance cheaper,’ contains many errors,” Charles Christianson wrote the Fargo Forum, though he only alludes to one thing he considers an error. Specifically my assertion that North Dakota’s uninsured rate for health insurance has been about 8 – 10 percent both prior to Obamacare and after it.
“The first and most glaring repeats the talking points of some Republican officials that the rate of North Dakotans without health insurance has ‘remained mostly unchanged’ with the ACA, varying between 8-10 percent of our population before and after ACA implementation,” he continues. “The US Bureau of the Census reports that the uninsured rate in North Dakota averaged 11.5 percent from 2009-2012, the last years before ACA implementation. It was never less than 10 percent. After implementation of the ACA the rate dropped to 7.9 percent for 2016 and 2017, a decrease of over 3 percent. Now around 47,000 North Dakotans have health insurance through the provisions of the ACA. That’s undeniable.”
It’s certainly undeniable that some 47,000 North Dakotans now get health insurance through one provision of Obamacare or another, but to use that number in a debate over the uninsured rate is a bit silly. How many of those folks had insurance prior to Obamacare? Changing the manner in which the already insured obtain their coverage is hardly addressing the uninsured problem.
Regardless, I based my post on information from the North Dakota Office of the Insurance Commissioner. In fact, Commissioner Godfread was on my radio show just last week talking about this very issue.
On Friday I emailed Godfread a link to Christianson’s letter and asked him about the numbers. “We are confident in our 8-10% numbers,” he told me by way of response, and he said his office reached that conclusion based on data from multiple sources.
“We rely on our own data for a lot of our numbers, but for the uninsured rate we use multiple sources, including some of our own data, because it’s a tough number to track, if someone doesn’t buy insurance there is no touch point for them to be tracked if that makes sense,” he continued.
Godfread sent me a link to a spreadsheet from the federal Department of Health and Human Services which shows the rate of uninsured in North Dakota prior to Obamacare hovering in the 8 – 10 percent region. He then notes that North Dakota’s uninsured rate in 2018, per the U.S. Census Bureau, is 8.1 percent.
I believe Godfread is right when he says this is a tough issue to track. Any metrics used to describe uninsured rates are bound to have a margin of error. That said, even if Obamacare did improve the uninsured problem by 3 percentage points as Christianson claims, that sort of marginal improvement, whether it’s real or not, is hardly something to crow about.