Of all the arguments to make for repealing and replacing Obamacare, the very worst is that people don’t need health insurance.
Yet this is a Trump administration talking point. White House press secretary Sean Spicer told reporters last week, “When we get asked the question, ‘How many people are going to get covered?’ that’s not the question that should be asked.” Pressed on the merits of the bill by George Stephanopoulos on ABC’s This Week, Office of Management and Budget director Mick Mulvaney shot back, “You’re worried about getting people covered.” As if that’s a woeful mistake.
This is a strange rhetorical tack for officials in an administration led by a president who pledged to cover everyone. Nor is it substantively or political defensible. Repealing and replacing Obamacare will require every ounce of persuasiveness that Republicans can muster, especially with the Congressional Budget Office now estimating that under Trumpcare, 14 million fewer people will be insured in 2018. The early signs aren’t encouraging.
It is true that health insurance isn’t a panacea. There is an academic debate about whether having health insurance leads to longer lives, and all sorts of factors besides insurance affect health and the quality of medical care (geography, for instance, can have more of an impact on care than whether someone is insured).
Still, there is abundant evidence of the benefits of insurance. Research has found that Romneycare in Massachusetts improved measures of physical and mental health. A Rice University study of the Houston area found that people with insurance report being in better health than those who lack it. If nothing else, insurance is protection against catastrophic health expenses and provides a sense of security.
This is true even of Medicaid, an insurance program so inadequate that it is the next best thing to having no insurance at all.