White House Claim of 46 Million Uninsured 'Americans' Includes Almost 10 Million Foreigners
June 15, 2009 - 6:46 PMThe claim made by the White House this month that 46 million "Americans" lack health insurance is false because that number includes almost 10 million people who are not "Americans" but in fact citizens of foreign countries.
The claim was made repeatedly in a report published by the White House Council of Economic Advisers (CEA) on June 2 and again in an op-ed published the same day by Christina Romer, the chair of CEA.
The claim that there are 46 million uninsured “Americans” has also been used by members of Congress and news organizations.
At a townhall meeting in Green Bay, Wis., last Thursday, President Obama twice referred to “46 million” people who lack health insurance, although in neither case did he describe those “46 million” as “Americans”—in one instance referring to them as “46 million people who don't have health insurance” and in another instance as “46 million uninsured."
On June 2, the White House released “The Economic Case for Health Care Reform,” a report by the president’s Council of Economic Advisers. In making the case for Obama’s health-care reform plan, this report repeatedly asserted that there are 46 million uninsured “Americans.”
That same day, CEA Chair Christina Romer published an op-ed on Yahoo! News asserting: “Health care expenditures in this country are currently 18 percent of GDP and, without change, will keep rising, until they account for nearly one-third of our total output by 2040. Even with this exorbitant bill, about 46 million Americans lack health insurance coverage today, and this number is predicted to rise to 72 million over the next three decades.”
“Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance,” said the CEA report itself. “CEA projections suggest that this number will rise to about 72 million in 2040 in the absence of reform.”
“In addition,” said the CEA report, “nearly 46 million Americans are currently without health insurance, and this number is projected to rise substantially.”
The CEA even used the claim of “46 million uninsured Americans” as a basis for some of its economic analysis, claiming that Americans could spend an estimated $46 billion per year less on health insurance if the 46 million uninsured Americans were covered.
“Some studies suggest that moving from the current system to an insurance exchange with widespread participation could bring down the price of health insurance by 20 percent, or roughly $1,000 per year for a typical uninsured individual,” said the report. “With 46 million uninsured Americans, this suggests an overall gap of about $46 billion per year, or more than 0.3 percent of GDP.”
Speaking on June 11 in Green Bay, President Obama said the fact that there are “46 million uninsured” demonstrates that the “free market fails.”
“What we're trying to explain is, is that all we’re trying to make sure of is that there is an option out there for people where the public--where the free market fails,” said Obama. “And we’ve got to admit that the free market has not worked perfectly when it comes to health care, because you've got a lot of people who are really getting hurt: 46 million uninsured.”
The CEA’s claim that there are “46 million uninsured Americans” is false because, according to the Census Bureau, 9.7 million of the approximately 46 million uninsured people in the United States are not American citizens. In other words, about 21 percent of the uninsured in this country are citizens of other nations who are living here.
According to “Income, Poverty, and Health Insurance Coverage in the United States,” a Census Bureau report published in August 2008, there were 45.6 million persons in the United States who did not have health insurance in 2007, the latest year for which figures are available. However, the report states that 9.7 million of these uninsured persons were not U.S. citizens.
The Census Bureau does not ask whether someone is legally or illegally present in the United States, so it is unknown how many of the 9.7 million uninsured foreign nationals were legal permanent residents of the United States and how many were illegal aliens.
Interestingly, the majority of non-citizens residing in the United States did in fact have health insurance. Of the approximately 22.2 million non-citizens residing in the country in 2007, says the Census Bureau, 12.5 million had health insurance, with 9.4 million covered by private plans.
Of the 299 million people in the United States in 2007, 253.4 million had health insurance. The vast majority of those—202 million—had private health insurance, according to the Census Bureau.
In a June 7 editorial arguing that Congress should increase taxes to help pay for universal health insurance, The New York Times echoed the claim of the Obama White House that there were “46 million uninsured Americans.”
“But Congressional Democrats will almost certainly need to come up with a lot more money--and that is likely to mean new taxes,” said the Times’s editorial. “There are at least two easy ways to duck the problem should Congress choose to be imprudent. One way out would be to abandon the goal of universal coverage until after costs have been controlled. That would be unfair to the 46 million uninsured Americans, who often suffer health damage because they are reluctant to seek treatment until their plight becomes desperate.”
Senate Finance Chairman Max Baucus (D.-Mont.), who is overseeing the development of health-care legislation in the Senate, referred to “46 million Americans without health insurance” at a March 27 forum sponsored by the Center for American Progress, where he argued that all “Americans” should be mandated to get health insurance.
“An individual obligation to get health coverage is essential for several reasons,” said Baucus. “It is the only way to stop the cost shifting related to uncompensated care. Today the cost of care for 46 million Americans without health insurance are largely borne by those with insurance. Getting all Americans covered will also make insurance markets function properly.”