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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

Bryan Walsh, author of Future
Updated 6 hours ago - Technology

A dark view of the future of autonomous weapons

A still from the video "If Human: Kill ( )." Image: Future of Life Institute

A new short film warns of the coming risks posed by the development and proliferation of lethal autonomous weapons.

Why it matters: Drones with the ability to autonomously target and kill without the assistance of a human operator are reportedly already being used on battlefields, and time is running out to craft a global ban of what could be a destabilizing and terrifying new class of weapon.

Updated 6 hours ago - Politics & Policy

Omicron dashboard

Illustration: Shoshana Gordon/Axios

  1. Health: Coronavirus variant surveillance varies widely by state — Omicron cases confirmed in 5 U.S. states America probably won't lead the effort to understand Omicron.
  2. Vaccines: Omicron adds urgency to vaccinating world — Omicron fuels the case for COVID boosters — Moderna loses patent battles tied to COVID vaccine — Pfizer could have vaccine data for children under five by end of 2021, CEO says.
  3. Politics: Nevada to impose insurance surcharge on unvaccinated state workers — New Jersey GOP lawmakers defy statehouse COVID policy — Oklahoma sues Biden administration over Pentagon vaccine mandate — Omicron travel bans are sign of what's to come.
  4. World: WHO: Delta health measures help fight Omicron — COVID cases surge in South Africa in sign Omicron wave is coming — Germany approves new restrictions for unvaccinated people.
  5. Variant tracker: Where different strains are spreading.
Updated 11 hours ago - Politics & Policy

Prosecutors charge parents of Michigan school shooting suspect

Photo: Scott Olson/Getty Images

The parents of a 15-year-old accused of killing four students and wounding seven other people at a Michigan high school have been charged with four counts of involuntary manslaughter, according to court documents.

The latest: Lawyers for James and Jennifer Crumbley told the Detroit News they are "returning to the area to be arraigned," after law enforcement officials announced a search for the Crumbleys had been initiated.