Insurance figures give Democrats new line of attack against Trump

Health care is back in the 2020 spotlight after new government figures showed the number of uninsured Americans increased for the first time in nearly a decade.

Democratic presidential candidates pinned the blame on President Trump, arguing his attacks on ObamaCare and his administration’s policies helped drive up the uninsured rate, eroding the hard-fought expansion in coverage achieved by the 2010 Affordable Care Act (ACA).

“20 million people gained coverage under ObamaCare. But after countless attacks on the law by the Trump administration, the uninsured rate increased for the first time since 2019,” tweeted former Vice President Joe Biden, the Democratic front-runner.

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“As president, I’ll defend and build on the ACA.”

About 2 million Americans last year joined the ranks of the uninsured, bringing the total to 27.5 million, according to figures released Tuesday by the Census Bureau.

The jump was the first such increase the survey reported since 2009, when the U.S. economy was in recession and shortly before major provisions of ObamaCare took effect.

“Trump and Republicans sabotaged the Affordable Care Act at every turn,” Sen. Kamala Harris (D-Calif.), another White House hopeful, tweeted on Tuesday. “They played politics with health care and now Americans are paying the price.”

Sen. Bernie Sanders (I-Vt.), who regularly polls in the top three among Democratic presidential candidates, said Trump has “lied” about strengthening the health care system.

“Instead, he has done everything he can to sabotage the Affordable Care Act,” Sanders tweeted Tuesday.

Congressional Democrats also hit Trump over his attempts to dismantle the ACA through actions like reduced funding for ObamaCare’s enrollment and outreach programs.

“President Trump’s cruel health care sabotage has left two million more people without health insurance, forced to live in constant fear of an accident or injury that could spell financial ruin for their families,” said Speaker Nancy Pelosi (D-Calif.).

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The GOP’s position on health care has proved a major liability for the party. House Democrats won back the House last year, and they credit much of that victory to their health care message, which focused on efforts by Trump and Republicans to repeal ObamaCare.

But the Trump administration has held firm since the midterm elections. The White House is supporting a GOP-backed lawsuit in federal court that aims to overturn ObamaCare.

Experts said the elimination of the individual mandate penalty — a repeal made by Republicans and approved by Trump in 2017 — could have contributed to the higher uninsured rate.

Census officials also said the increase in the uninsured rate was mostly driven by a decline in the number of people enrolled in public programs like Medicaid, the federal insurance program for the poor.

The administration has encouraged states to impose stricter requirements for beneficiaries to prove that they are eligible for Medicaid.

“There’s a pretty long history showing when states put more reporting requirements in or increase the administrative requirements for enrollees, people tend to fall off coverage,” said Rachel Garfield, co-director of the Kaiser Family Foundation’s program on Medicaid and the uninsured.

The Obama administration allowed states to expand Medicaid to cover more low-income adults, but Trump has prioritized policies that would decrease enrollment.

Work requirements that were briefly in effect last year in Arkansas before being blocked by a federal judge mandated that Medicaid beneficiaries provide proof every month that they were employed.

About 20,000 state residents lost coverage, largely for failing to complete the administrative requirements.

While every Democrat running for president supports ObamaCare’s Medicaid expansion, which allowed 36 states and D.C. to expand the program to cover more low-income adults, the administration argues the program should be reserved for the elderly, pregnant women and children.

Health experts were particularly alarmed by the increase in the number of children without health insurance last year.

Overall, 4.3 million children didn’t have insurance in 2018, an increase of 425,000 from 2017.

“The Trump administration is encouraging states to increase the red tape that families are experiencing when they apply for Medicaid or try to renew their Medicaid, and as a result, eligible children are falling through the cracks,” said Joan Alker, executive director and co-founder of the Center for Children and Families at Georgetown University.

The administration argues that Medicaid enrollment has dropped because people are getting better jobs and are no longer eligible for the program.

Tuesday’s Census figures showed fewer people living in poverty in 2018 compared with the previous year. 

But the decline in Medicaid enrollment hasn’t corresponded to an increase in private and employer-based coverage. That could partly be attributed to workers with low-wage jobs that don’t offer health benefits but pay too much to allow them to qualify for Medicaid.

The Department of Health and Human Services did not respond to a request for comment about the Census figures.

Health experts also said the administration’s actions on immigration are discouraging some foreign-born residents from enrolling in Medicaid or related federal programs.

“We believe that many of those families are too scared to interact with the government,” Alker said. “This includes many families where the child is a citizen and the parent is an immigrant.”

The Census data showed Hispanic children were more likely than children of other groups to go without insurance.

The uninsured rate among Hispanic children increased by 1 percentage point last year, compared to half a percentage point among white children.

But the Census figures could also add to internal fighting among the field of 2020 Democrats, with some focusing on protecting ObamaCare and others backing “Medicare for All.”

“Under Medicare for All, we will guarantee health care to everyone in America and bring the uninsured rate down to where it belongs: zero,” the Sanders campaign said in a statement. 

Democratic National Committee Chairman Tom Perez, however, said the party is united in its health care efforts.

“Democrats believe that access to quality, affordable care is a right for all, not a privilege for the wealthy,” he said Tuesday. “And that’s why we’re going to win up and down the ballot in 2020.”