In 2024, the uninsured rate in the United States hit its lowest point ever, with just 8.2 percent of people uninsured. For those who had spent careers working to expand people’s access to affordable, high quality health insurance, it felt like we could finally say, “Mission (almost) Accomplished.” Thanks to the Affordable Care Act, 44 million people had gained insurance coverage through Medicaid and the health insurance Marketplaces, and 160 million more with employer-sponsored insurance had peace of mind that, if they did lose their job or need to take time off, there was a safety net to catch them.
At CHIR, we know that health insurance coverage matters. It improves access to primary care, preventive care, and timely care for emerging health conditions. It ensures a healthier population and drives productivity. It provides essential financial security.
For millions of Americans, the peace of mind that comes with health insurance is now gone. With the passage of H.R. 1, the budget reconciliation bill, Congress and the President have shredded the social safety net.
Up to 17 million people will be thrown off their health insurance; millions more will face higher barriers to accessing critical services. Hospitals, physicians, and other health care providers will lose over $1 trillion in revenue and face roughly $278 billion in uncompensated care costs, prompting up to 300 rural hospitals and many community health centers to close their doors. H.R. 1 amounts to an effective repeal of the Affordable Care Act and reverses a decade of progress.
The challenges ahead are enormous. At CHIR, we’ll be supporting the Marketplaces, insurance regulators, and other stakeholders in their efforts to implement this law while, to the extent possible, minimizing harms to consumers and plan enrollees. We’ll partner with researchers, the media, regulators, and policymakers to document and publicize the law’s effects on people’s ability to obtain, and maintain, the coverage for which they are eligible. And we’ll work with anyone interested in an accessible, affordable and equitable health system to identify and take advantage of opportunities to reverse the law’s worst abuses. As Mr. T once said, “To have a comeback, you got to have a setback.” At CHIR, we’re rolling up our sleeves and working towards that comeback.
