The Census Bureau released the latest data on the number of Americans without health insurance. Surprisingly, the numbers went down.
The federal government reported that in 2007, 1.3 million more people had health insurance than in the previous year. Both the percentage and number of people without health insurance decreased in 2007. The percentage without health insurance was 15.3 percent in 2007, down from 15.8 percent in 2006. The number of uninsured was 45.7 million, down from 47 million.
"All of that decline can be attributed to improvement in government health insurance programs, which constitute the nation's safety net insurance programs," said Karen Davis, president of the Commonwealth Fund research group.
Programs expanded include Medicaid and state health insurance plans for low income children, or SCHIP. In fact, the biggest jump was among children — about 600,000 more children now have health insurance.
In the private sector, however, the news isn't as good.
The trend among small businesses to drop or curtail health benefits to employees continues.
"Employers are finding premiums harder and harder to afford," Davis said. "They don't get the same premiums as do large employers and workers are finding it harder and harder to pick up their share of the premium."
Diane Rowland, executive vice president of the Kaiser Family Foundation, says the decrease is good news, but overall the situation remains dire because 45.7 million Americans still have no health insurance and millions more are underinsured.
"What these numbers show today is that the uninsured aren't going to decrease magically even if there's been a slight decline in 2007," she said. "This is going to be a big issue. Its not going away.
"State efforts can help to decrease this when the economic times are good, but states get in economic straits when the economy turns downard and that means federal action is most likely going to have to be there if we're ever going to address the substantial number of uninsured."
Both presidential candidates have described the current healthcare system as costly and in need of reform. John McCain and Barack Obama both back subsidies and tax credits to help individuals buy insurance. Obama would require all parents to cover children under 18. He would expand public programs to make sure children of lower-income families have coverage.
The highlight of McCain's proposal is a $5,000 tax credit for families.
Rowland says the big question is will any of it really help, especially when the cost of a typical comprehensive insurance plan for a family of four is $13,000 a year and and growing.
"In any reform proposal, one of the debates is going to be: At what level of income do you provide assistance to people? When are people 'well off enough' to be able to afford their own coverage without any assistance from the federal government?" she said.
The major squeeze: The bigger the help, the bigger the cost. The money to pay for expanded health coverage has to come from somewhere — either from employers, including small businesses, or from individuals. Obama would require employers to either provide benefits or contribute to a fund that would provide coverage. McCain makes no such rules for employers or individuals.
Neither candidate is particularly deep on details, something Rowland calls a good political decision.'
"I think if history provides any lessons, it's that the more details a candidate provides before election, the more strings are tied around them when they try to act after elected," she said. "I know the media and the analysts will be pushing these candidates to try and be more specific, but I think one of the lessons of the Clinton health reform battles is that to be too specific too early may be putting the prospect of reform farther out of reach."