Rep. Virginia Foxx uses questionable stats to attack health care reform
In an interview with The Mount Airy News, a newspaper based out of Mount Airy, N.C., (a small town best known as the inspiration for Andy Griffith’s Mayberry), Rep. Virginia Foxx (R-N.C.) asserts there is plenty of access to health insurance in the U.S. when the true picture is much murkier.
Advocates of health care reform have often pointed to the full one-sixth of Americans who are without health insurance as a symptom of an institution in need of fixing. Foxx says the figure of 50 million is misleading because it is made up primarily of people who can either afford health care or qualify for pre-existing programs.
Foxx contends that if you take away illegal immigrants, those who can easily afford private coverage and people who qualify for Medicare and Medicaid, the actual number of “uninsurable” Americans as such is more like 7 to 10 million. She says that this is a much more manageable figure and could possibly be covered with a voucher program rather than a comprehensive overhaul of health care itself.
If Foxx is correct, her claim would certainly be worth examining in the debate over health care. But is she? Using Census data on the uninsured, even the loosest application of statistics doesn’t cut the 50 million down to 10 million.
Of the 50,674,000 who reported not having any form of health insurance in 2009 (and indeed, the numbers are likely even higher now; the 2009 figure included over 4 million more people than went without insurance in 2008), well under a million could conceivably have qualified for Medicare. There were 676,000 people over age 65 in 2009 who didn’t have health insurance.
From there, the numbers get hazier. Foxx must have based the notion that a big chunk of the 50 million are eligible for Medicaid on the fact that nearly 15.5 million Americans without insurance had household income below $25,000 in 2009. That’s hardly a good metric because it doesn’t account for household size, but it’s as detailed as the Census data gets, and it’s within $400 of 133 percent of the federal poverty line for a three-person household. Other Census data show that median household income overall is closest to median household income for families of three, and 133 percent of the poverty line is the financial eligibility criterion for most people seeking Medicaid coverage. Fuzzy math to be sure, but then, it’s very generous to Foxx’s assessment; let’s say giving her the benefit of the doubt allows it.
Another of Foxx’s categories, those who can afford it but elect not to buy insurance, correlates to the 10.56 million belonging to households earning more than $75,000. Again, for Foxx’s sake, we can go ahead and use this figure. Finally, there are the illegal immigrants. There are 9,936,000 non-citizens living in the U.S. without health insurance. If we assume that every last one of them is an illegal immigrant (though this is patently not the case), that’s a final tally of 36,656,000 Americans who Foxx might say are perfectly capable of obtaining some form of health insurance. This leaves 14 million without any type of insurance available to them, higher than Foxx’s claim of 7 to 10 million.
And yet even 14 million is surely low to an incredible degree. There may well be 676,000 seniors who should be able to get Medicare but haven’t signed up — though those who haven’t been a part of the Social Security system or worked consistently throughout their lives would be ineligible. But numbers obtained for the other categories are likely not even close. Medicaid eligibility is based not on poverty alone, but also on either having children in the household or having certain disabilities. Able-bodied adults with no children living with them must make up at least a portion of those 15.5 million.
Assuming that all households earning over $75,000 can afford health insurance is also problematic, because it doesn’t account for households that include multiple income sources, for example, from extended family living under one roof, a common configuration among many ethnic and racial minority groups. Of course, the idea that all non-citizens without health insurance are illegal immigrants rather than permanent residents cannot be accurate, and the premise that undocumented immigrants are categorically undeserving of health insurance simply goes unquestioned in the Mount Airy News article.
And all these qualifications still don’t account for overlap among the various uninsured groups. For example, many of the non-citizens without insurance likely also fall into the low-income group; many of the senior citizens must fall into both the low- and high-income groups; and so on.
Ultimately, there just isn’t enough data to tell how many uninsured Americans could conceivably qualify for some type of health insurance under our current system. It may not be 50 million, but it is certainly more than the 7 to 10 million that Foxx claims. She is sure of one thing, though: Foxx says people shouldn’t use health insurance for preventive checkups or non-emergencies. She denounces annual checkups and compares doctor visits for colds to expecting home insurance to pay for a light bulb. “That’s not what insurance was designed to do,” says Foxx. “It’s designed to do the big things.”