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The number of insured Americans just hit a new high

This is the web version of VoxCare, a daily newsletter from Vox on the latest twists and turns in America’s health care debate. Like what you’re reading? Sign up to get VoxCare in your inbox here.

More Americans had health insurance during the first three months of 2017 than ever before, new federal data shows.

The National Center for Health Statistics published data Tuesday showing that 8.8 percent of Americans lacked coverage in a survey conducted from January to March of this year. This is relatively similar to (albeit a bit lower than) the numbers this federal center has recorded in recent years.

Their data shows that 20.5 million Americans have gained coverage since 2010, the year the Affordable Care Act became law.

The biggest gains in insurance coverage have been for minority groups and low-income Americans. The uninsured rate for Hispanic Americans, for example, fell from 40.6 percent in early 2013 (the year before Obamacare’s coverage expansion took effect) to 24.1 percent in early 2017.

And here’s the chart that divides up uninsured rates among those who are near poverty or below the poverty line. Again, you see the sharpest declines in uninsured rates are among the poorest Americans.

This report makes clear that millions of Americans are gaining health coverage. But it also shows that the type of coverage Americans receive is changing, too. The report shows a rapid rise in the number of high-deductible insurance plans. This report defines “high-deductible” as at least $1,300 for an individual policy and $2,600 for a family.

In 2010, when the National Center for Health Statistics first started asking about these plans, 25.3 million Americans were enrolled in high-deductible coverage. Now, in 2017, that number has jumped up to 42.3 million. About one-third of these high-deductible plans are paired with Health Savings Accounts (HSA) that individuals can put toward their out-of-pocket costs.

Taken together, these graphs help tell the story of what is popular about Obamacare — and what isn’t. Most people who have gained coverage through the health care law are pretty happy about the fact that they got a plan. Having insurance is better than going uninsured.

But there is still significant frustration among Obamacare enrollees (and, increasingly, among those with employer-sponsored coverage) that the plans require significant out-of-pocket payments. The plans sold on the Obamacare marketplaces can have deductibles as high as $6,000 for individuals and $13,000 for families. These plans do not come with an HSA to defray out-of-pocket costs. Enrollees have to pay their way through that entire deductible; many won’t use enough health care to do so.

Polls of Obamacare enrollees find that these high deductibles are their biggest frustration — but it’s a difficult issue to solve. It requires either spending more money subsidizing Obamacare plans (not likely when Republicans control Congress) or regulating medical prices to drive down what people pay when they go to the doctor (not likely when any party is in control of Congress). This is one frustration that is likely to stick around, even among those happy to gain coverage, with no solution on the horizion.

Chart of the Day

Javier Zarracina / Vox

All the rain that’s fallen over Houston so far, in one massive water drop. We’ve been covering how the health care system will handle Hurricane Harvey here in VoxCare — and this graphic from Vox’s Javier Zarracina helped me understand what an immense challenge they’re up against. If you’ve been having trouble wrapping your head around the size of the storm, this piecefrom Javier and Brian Resnick is worth a read.

Kliff’s Notes

With research help from Caitlin Davis

Today’s top news

  • “Kasich, Hickenlooper reach deal on ObamaCare markets”: “Govs. John Kasich of Ohio (R) and John Hickenlooper of Colorado (D) announced Monday that they have reached an agreement on a bipartisan proposal to stabilize ObamaCare markets. The governors, who have been calling for bipartisanship on healthcare in a series of recent interviews, are not yet releasing the details of their stabilization plan.” —Peter Sullivan, the Hill
  • “DCCC Launches Health Care Facebook Ads in Targeted Districts”: “The Democratic Congressional Campaign Committee is launching a new Facebook ad campaign aimed at nearly all of its 80 GOP targets that highlights the Republican health care bill. The ads are targeted at Republicans who voted for the bill — and even Republicans who voted against it.” —Bridget Bowman, Roll Call
  • “Storm flooding engulfs MD Anderson Cancer Center, canceling treatments for days”: “Tropical Storm Harvey has flooded the roads in and around MD Anderson’s primary Houston hospital, leaving one of the world’s foremost cancer centers unable to see patients for appointments or previously scheduled treatments until Thursday at the earliest.” —Casey Ross and Kate Sheridan, STAT

Analysis and longer reads

  • “Gov’t report: 28.1M in US lack health coverage”: “The government says about 500,000 fewer Americans had no health insurance the first three months of this year, but that slight dip was not statistically significant from the same period in 2016. Progress reducing the number of uninsured appears to have stalled in the last couple of years, and a separate private survey that measured through the first half of 2017 even registered an uptick.” —Associated Press
  • “Home Health Care: Shouldn’t It Be Work Worth Doing?”: “Care providers — home health aides, personal care attendants and certified nursing assistants, in the government’s classification — are expected to be among the nation’s fastest-growing occupations. The Department of Labor’s economists expect about a million more will be added from 2014 to 2024. And yet despite their critical importance to the well-being of tens of millions of aging Americans, one-fourth of these aides live in poverty.” —Eduardo Porter, New York Times
  • “Mayo Pain Expert: Holistic Approach Helps Patients Ditch Opioids”:“Mayo’s program isn’t the only one to address the emotional, social and psychological aspects of pain, and other programs also focus on reducing patients’ reliance on addictive medications to manage their pain. But as the nation weathers an opioid epidemic, there are too few programs like these around the country to address the need, [Clinical Director Wesley] Gilliam said.” —Michelle Andrews, Kaiser Health News

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