THE PROGNOSIS

Maybe the number of people without health insurance isn’t dramatically worsening under the Trump administration, at least not yet.

Yes, some recent polls have indicated more Americans are dropping off health coverage after big gains under the 2010 Affordable Care Act. But a big, government survey released this morning shows only a tiny — and statistically insignificant — uptick in the share of Americans lacking coverage in 2017 compared to the year prior.

Last year, 9.1 percent of Americans didn’t have health insurance (that translates to 29.3 million people), according to a report on health insurance based on the National Health Interview Survey from the Centers for Disease Control and Prevention. That’s a negligible difference from the 9 percent of Americans without insurance in 2016.

You could read this survey two ways. First, it’s pretty unfortunate the U.S. still finds itself in a situation where a large share of the population — nearly 1 in 10 people — lack health coverage. For all our policymakers’ and lawmakers’ hand-wringing, they haven’t managed to put the country on par with most developed countries, which enjoy uninsured rates in the low single digits.

Second, it’s not yet clear that policies advanced by the Trump administration to eliminate parts of the ACA have done much yet to shrink its insurance expansions. Still, over the past few months, Democrats and liberals have been seizing on any indication they can find that the GOP-led administration is throwing people off health insurance.

“The Trump administration has spitefully tried to undermine the Affordable Care Act by eviscerating funding for ACA open enrollment advertising, deliberately creating massive confusion around ACA enrollment availability and making constant threats to cut off key ACA payments,” top House Democrat Nancy Pelosi (Calif.) said in January. “Together, these efforts have pushed the number of uninsured Americans up for the first time in a decade.”

Pelosi was referring to a Gallup survey released in January, which found that 3 million fewer people had health insurance at the end of 2017 relative to the end of 2016, based on more than 25,000 interviews. Another Gallup survey released this month and involving 160,000 interviews found the uninsured rate rose by statistically significant margins in 17 states last year.

And the Commonwealth Fund reported that the uninsured rate among non-senior adults rose from 12.7 percent in 2016 to 15.5 percent last year, based on interviews in February and March with 2,400 adults.

The negative picture painted by these surveys could turn out to be true, especially once we get a better sense of how people will respond when the penalty for lacking health coverage goes away next year.

And even if the insured rate remains relatively steady, more people will have access to somewhat leaner insurance coverage under policies the Trump administration is advancing. There is a trend, reconfirmed by today’s NHIS survey data, of more Americans buying high-deductible policies requiring them to pay a hefty sum before their benefits fully kick in. The survey found that 43.7 percent of privately insured people enrolled in a high-deductible health plan last year, compared to 39.4 percent in 2016.

But will the Trump administration, with its antagonism to the ACA, significantly reverse the Obamacare's coverage gains? The NHIS survey is one of the best indicators we have of insurance coverage in the United States — and it seems to indicate the jury’s still out.

The survey got started in 1957 after Congress passed legislation authorizing the Public Health Service to annually collect information on the Americans' health status and behavior. It’s designed by the CDC’s National Center for Health Statistics and administered by the Census Bureau. Instead of being taken over a few days or weeks, the survey is conducted throughout the year, drawing from a nationally representative sample each month.

Here are some of the survey’s other findings, from more than 78,000 people interviewed:

  • Among non-elderly adults, 12.8 percent are uninsured; 69.3 percent have private coverage and 19.3 percent have public coverage.
  • Among children under age 18, 5 percent are uninsured, 55 percent have private coverage and 41.3 percent have public coverage.
  • The uninsured rate is 27.7 among Hispanics, 14.1 percent among blacks, 8.5 percent among whites and 7.6 percent among those of Asian origin.

Correction: An initial version of this story stated there were 9 million Americans uninsured in 2016. The Health 202 has changed to clarify that 9 percent of Americans were uninsured.

AHH, OOF and OUCH

AHH: California is set to become the first state to provide health coverage to undocumented immigrant adults. “The proposal…  is one of the most daring examples yet of blue-state Democrats thumbing their nose at President Donald Trump as they pursue diametrically opposed policies, whether on immigration, climate change, legalized marijuana or health care,” Politico’s Victoria Colliver reports.

State Sen. Ricardo Lara has authored a bill to extend Medicaid coverage to eligible adults in California regardless of their immigration status, costing a hefty $3 billion per year. He and other Democrats say they want to build on the coverage gains made under the ACA by focusing on the state's nearly 3 million remaining uninsured. About 60 percent of this population (1.2 million people) are undocumented immigrants who would qualify for the state’s Medicaid program, known as Medi-Cal, based on their incomes.

California Gov. Jerry Brown (D), who is leaving office later this year, has not yet committed to the plan, Victoria reports. "[He's] required by law to sign or veto bills passed this session by Sept. 30, just five weeks before the midterm elections," she writes. "And the injection of immigration politics into the universal health care debate will likely provide talking points for both parties."

OOF: Five women are suing the University of Southern California, alleging sexual abuse by the school’s former gynecologist, Dr. George Tyndall. The lawsuits, filed yesterday, are likely just the first of many and could signal extended litigation and large financial settlements in the growing scandal, Tim Arango writes for the New York Times. Four unnamed women have filed a second lawsuit calling the former gynecologist a “serial sexual predator” and blaming the school for “actively and deliberately” covering up Tyndall’s predations for years.

"The lawsuits stem from an investigation published last week by The Los Angeles Times that accused Dr. Tyndall of abusing patients for years at the university," Tim writes. "The case has raised difficult questions about how the university’s senior leadership has handled the case, with some students circulating a petition demanding the resignation of C.L. Max Nikias, the university’s president....The complaints in the two lawsuits outline in vivid detail a litany of alleged abuses and inappropriate sexual comments by Dr. Tyndall over years."

OUCH: African American kids are taking their lives at about twice the rate of their white counterparts, according to a new study that shows a widening gap between the two groups, The Post's Amy Ellis Nutt reports. The 2001-2015 data, published yesterday in the journal JAMA Pediatrics, confirms a pattern first identified several years ago when researchers at Nationwide Children's Hospital in Ohio found that the rate of suicides for black boys and girls ages 5 to 12 exceeded that of young whites.

It's a startling finding because historically, suicide rates in the United States have been higher for whites than blacks across all age groups. That remains the case for adolescents ages 13 to 17, according to the new study. White teens continue to have a 50 percent higher rate of suicide than black teens.

Lead author Jeffrey Bridge said the latest findings reinforce the need for better research into the racial disparities. “In 2017, research by Bridge and colleagues found that among children, ages 5 to 11, and young adolescents, ages 12 to 14, those who  took their own lives were more likely to be male, African American and dealing with stressful relationships at home or with friends,” Amy writes. “Children who had a mental health problem at the time of death were more likely than young adolescents to have been diagnosed with attention-deficit disorder or attention-deficit hyperactivity disorder.”

MEDICAL MISSIVES

— An Ebola vaccination campaign began yesterday in Congo in an effort to combat the recent outbreak. One day earlier, the health ministry announced a nurse had died in Bikoro, bringing the total death toll to 27, the AP's Saleh Mwanamilongo reports. The experimental vaccine, which is being provided by Merck, is still in testing stages, but was effective toward the end of the Ebola outbreak that killed more than 11,300 people in Guinea, Sierra Leona and Liberia from 2014 to 2016.

Congo’s health delegation, which includes the health minister and representatives of the World Health Organization and the United Nations, arrived for the campaign in Mbandaka, a port city on the Congo river with a population of 1.2 million where Ebola cases have been identified, Saleh writes.

— Another cold case has been cracked with the help of DNA information on a public genealogy website. Since November 1987, police received more than 300 tips about people who thought they had information about the alleged killer of a couple from Saanich, British Columbia. Those tips didn’t include William Earl Talbott II. But when investigators ran the killer’s DNA from the scene through the genealogy website GEDMatch, the information led them to Talbott, our colleague Meagan Flynn reports.

“Now they have charged Talbott, 55, with murder, saying his DNA profile found through his ancestors this month matches the DNA left at the crime scene 31 years ago,” Meagan writes.  “Talbott’s arrest marks the latest case in which detectives have nabbed a suspected killer using controversial familial DNA methods, taking advantage of public genealogy websites…to identify the suspect’s distant relatives and begin mapping his family tree.”

The arrest follows the use of the same website last month to track down relatives of Joseph James DeAngelo, the suspected Golden State Killer who allegedly committed a dozen murders and 45 rapes across California in the 1970s. The case led to a debate about the ethics of using public DNA information for police investigations.

AGENCY ALERT

— Today, Health and Human Services Secretary Alex Azar will attend the 71st World Health Assembly in Geneva, Switzerland, HHS officials have confirmed. The WHA is the decision-making body of the World Health Organization. Along with delivering a speech on the U.S. commitment to global health security, Azar will also attend official events focused on key public health challenges and participate in multiple bilateral meetings with health ministers and officials from other nations.

— A few more good reads from The Post and beyond:

HEALTH ON THE HILL
Sen. Chuck Grassley (R-Iowa) is looking to pass a bill to bring more cheap, generic drugs to market.
The Hill
STATE SCAN
Supervised injection sites for heroin users have prevented overdose deaths in Canada. But is New York City ready for the scenes that come with them?
New York Times
Virginia Politics
Many of the low-income, uninsured residents who would get care have jobs — or did before their health failed.
Laura Vozzella
D.C. Politics
First-term mayor announced that she adopted a newborn baby
Fenit Nirappil and Martin Weil
INDUSTRY RX
Biotech companies and pharmacy benefit managers are outperforming the market, despite new pressure on drugmakers.
CNBC
SECOND OPINION
David Goodall’s physician-assisted suicide raises wider questions.
Vox
DAYBOOK

Today

  • The Senate Health, Education, Labor and Pensions Committee holds a hearing on addressing shortages and improving care.
  • The House Veterans Affairs Committee holds a hearing on “Assessing VA's Governance Structure.”

Coming Up

  • The Senate Health, Education, Labor and Pensions Committee holds an executive session on “Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018” on Wednesday.
  • The Senate Appropriations Subcommittee on Interior, Environment and Related Agencies holds a hearing on the Indian Health Service 2019 budget on Wednesday.
  • The House Veterans Affairs Subcommittee on Economic Opportunity holds a legislative hearing on Wednesday.
  • The Senate Banking, Housing and Urban Affairs Committee holds a hearing on the status of the “Housing Finance System” on Wednesday.
  • The House Energy and Commerce Subcommittee on Health holds a hearing on “Reauthorization of the Children’s Hospital Graduate Medical Education Program” on Wednesday.
  • The Brookings Institution holds an event on opioids on Wednesday.
  • The Senate Finance Committee holds a hearing on rural health care on Thursday.
  • The Brookings Institution holds an event on medical marijuana in the United States on May 29.
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