A new analysis of federal surveys on health insurance coverage concludes that the number of uninsured Americans increased by about 2.3 million between 2016 and 2019. The analysis by researchers at Harvard Medical School and the City University of New York’s Hunter College, published today in Health Affairs blog, concludes that the contraction of coverage under President Trump caused at least 3,399, and perhaps as many as 25,180, excess deaths even before the onset of the COVID-19 pandemic.
The researchers examined results of three benchmark federal surveys that collect data on health insurance coverage—the American Community Survey (ACS), the Current Population Survey, and the National Health Interview Survey. All three surveys indicate that uninsurance has risen under President Trump, but the researchers cite the ACS results as the most reliable. (Changes in methodology and data collection processes since 2016 hinder interpretation of year-to-year changes in the other two federal surveys). Using the ACS-based data indicating that the number of uninsured Americans has risen by 2.3 million, the researchers calculated the number of resulting excess deaths by applying estimates of the mortal consequences of being uninsured from previous rigorous, peer-reviewed studies.
“I see that my uninsured patients often can’t get the care they need, and research proves that many who lack coverage die as a result,” noted study author Dr. Steffie Woolhandler, a Distinguished Professor of Urban Public Health at Hunter College and Lecturer at Harvard Medical School. “President Trump has tried at every turn to undermine the ACA and chip away at coverage. That’s costing thousands of lives,” she added.
“Our analysis warns that much worse is ahead if the Supreme Court overturns the ACA, as Trump’s Justice Department is advocating,” stated lead author Dr. Adam Gaffney, a pulmonary and critical care physician at Harvard Medical School and the Cambridge Health Alliance. “Gutting the ACA would throw another 19.9 million Americans off of insurance, and cause up to 68,345 extra deaths each year. We need to expand insurance, not shrink it. With 30 million uninsured today, we could save thousands of lives by achieving universal coverage,” he added.