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Expand chart
Data: Kaiser Family Foundation; Chart: Axios Visuals

The House Ways and Means Committee recently held a hearing about universal coverage, examining incremental and more sweeping Medicare for All style strategies for getting to universal coverage. That means one way or another everyone would be covered, right?

The catch: In practice, universal coverage will not mean 100 percent coverage, because making everyone eligible for some form of coverage or financial assistance does not mean everyone will actually get covered. Even under Medicare for All, some populations could be left out.

  • That reality does not make it a less worthy goal to work to expand coverage as much as possible.

By the numbers: Thanks to progress made under the Affordable Care Act, we are at 90% coverage now. As the chart shows:

  • More than half of the remaining 27 million uninsured are eligible for coverage now, or for subsidies to help them get coverage, but remain uninsured — mostly because insurance is not affordable for them.
  • A separate significant share, 4.1 million, are ineligible because of immigration status. Only one state, California, seems interested in covering some of this population.

The big picture: Making people eligible for coverage or financial help does not assure they all get covered, and that that would remain the case whether we expanded eligibility for subsidies, expanded Medicaid in more states, put in place reinsurance mechanisms, or revitalized outreach and enrollment efforts, to pick several of the incremental policies that have been proposed.  

  • A pragmatic definition of universal coverage through incremental measures might take us to something like 95% coverage of the non-elderly population. That’s a guesstimate; it could just as easily be 96% or 94%.

We could cover everyone from birth through a Medicare for All style plan. But for that to happen, progressive Democrats would have to have substantial control of the White House, the House and Senate — and overcome fierce interest group opposition.

  • And to win passage, it’s possible that a political compromise would be necessary that would exclude coverage for the millions who are ineligible for coverage now due to their immigration status.

The bottom line: Universal coverage is a powerful rallying cry for Democrats and an important goal for progressive voters in the primary elections. But to appeal to as many voters as possible, making health insurance affordable for everyone — including by covering as many of the remaining uninsured as possible — might be a more effective rallying cry for the general election.    

Go deeper

Updated 3 hours ago - Health

California surpasses 50,000 COVID-19 deaths

A man prepares a funeral arrangement in in Los Angeles, California, Feb. 12. Photo: Mario Tama/Getty Images

California's death toll from COVID-19 surpassed 50,000 on Wednesday, per Johns Hopkins data.

The big picture: It's the first state to record more than 50,000 deaths from the coronavirus.

4 hours ago - Technology

Facebook bans Myanmar military

A protester holds a placard with a three-finger salute in front of a military tank parked aside the street in front of the Central Bank building during a demonstration in Yangon, Myanmar. Photo by Aung Kyaw Htet/SOPA Images/LightRocket via Getty Images

Facebook said on Wednesday it would ban the rest of the Myanmar military from its platform.

The big picture: It comes some three weeks after the military overthrew the civilian government in a coup and detained leader Aung San Suu Kyi, causing massive protests to erupt throughout the country. Military leaders have been using internet blackouts to try to maintain power in light of the coup.

It's harder to fill the Cabinet

Data: Chamberlain, 2020, "United States of America Cabinet Appointments Dataset" Chart: Will Chase/Axios

It's harder now for presidents to win Senate confirmation for their Cabinet picks, an Axios data analysis of votes for and against nominees found.

Why it matters: It's not just Neera Tanden. The trend is a product of growing polarization, rougher political discourse and slimming Senate majorities, experts say. It means some of the nation's most vital federal agencies go without a leader and the legislative authority that comes with one.