Despite calls to start over, US health system covers 90%

WASHINGTON (AP) — America’s much-maligned health care system is covering 9 out of 10 people, a fact that hasn’t stopped the 2020 presidential candidates from refighting battles about how to provide coverage, from Bernie Sanders’ call for replacing private insurance with a government plan to President Donald Trump’s pledge to erase the Affordable Care Act and start over.

The politicians are depicting a system in meltdown. The numbers point to a different story, not as dire and more nuanced.

Government surveys show about 90% of the population has coverage, largely preserving gains from President Barack Obama’s years. Independent experts estimate that more than one-half of the roughly 30 million uninsured people in the country are eligible for health insurance through existing programs.

Lack of coverage was a growing problem in 2010 when Democrats under Obama passed his health law. Now the bigger issue seems to be many people with insurance are struggling to pay their deductibles and copays.

A report this year by the Commonwealth Fund think tank in New York found fewer uninsured Americans than in 2010 but more who are “underinsured,” a term that describes policyholders exposed to high out-of-pocket costs, when compared with their individual incomes. The report estimated 44 million Americans were underinsured in 2018, compared with 29 million in 2010 when the law was passed. That’s about a 50% increase, with the greatest jump among people with employer coverage.

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