The Approach – It’s All About the People!

When you review the calculations located on this page, you will see the projections are all based on the changing USA population demographics, specifically, the aging of the huge Baby Boomers generation (80+ million left) into Medicare, and the larger Millennial generation (100+ million), median age 28 today, while keeping in mind that the X generation only has ~60 million people.   This was also noted on a recent Report from the CMS Actuary.  

It is important to note these uneven Demographic groups, and the 2008 Recession, created havoc in the predictions of the future number of uninsured.  The Recession, led to plummeting birth rates and immigration rates for the last 10 years.  With regards to population, the Baby Boomers and Boomer-age immigrants started turning 65 in 2012, ~3 million per year at first, now ~5 million per year, while birth rates plummeted to well under 4 million per year.  This is why CMS reported that an additional ~1 million people signed up for Medicare in 2016, 2017 and 2018 than were expected to sign up when PPACA was signed into law.

In fact, the recent Report from the CMS Actuary predicted that these changes, along with the Repeal of the Individual Mandate would result in ~39 million uninsured, contrary to the original CBO Analysis that estimated ~54 million uninsured in 2026, from early 2017.  The response from CBO  was simply that they had made some “significant” assumptions and that the CMS Actuary was the “realistic” estimate.  It is important to note that historically speaking, anything under 10% Uninsured is really good, meaning one would expect ~30 million to stay uninsured, or be transitionally uninsured.

Population Demographics

Starting with some basic demographic data in this section; and links are provided to some supporting data…

Let’s do some math!

How people had insurance in 2015: USA Population = 320 million

  • 54% Employer = 172.8 million
  • 7% Individual = 22.4 million (On & Off-Exchange)
  • 24% Medicaid = 76.8 million
    • 50% Age 65+ & Disabled = 38.4 million
  • 14% Medicare = 44.8 million
  • 2% other Public = 6.4 million
  • 2% VA Benefits = 6.4 million
  • 9% uninsured = 28.8 million

*Note: Dual eligible Medicaid-Medicare recipients are double-entries; therefore, the percentage’s are above 100%.

Fast Forward to 2030… USA Population = 355 million

  • 54% Employer = 191.7 million
  • 27% Medicare = 95.9 million (51.1 million MORE than in 2014)
  • 2% VA Benefits = 7.1 million

Total = 294.7 million or 83% of USA Population – only 60.3 million left to insure.

Therefore, all these must decrease by 2030:

  • 7% Individual = 24.8 million (On & Off-Exchange)
  • 24% Medicaid = 85.2 million
    • 50% Age 65+ & Disabled = 42.6 million
  • 2% other Public = 7.1 million

Total = 84.5 million to insure at the same percentages, or 24.2 million (40%) more than the number of people available to insure!  Once you add in Medicaid, the Individual and Uninsured percentages will all drop significantly as Baby Boomers enroll in Medicare! However, that’s a whole new problem for Medicare!  

***If the 24 million number looks familiar, it is because it aligns with the CBO Reports miscalculations since 2012.  Coincidence? 



In this section, you will find links to other sites with data; and documents I have previously distributed, including Public Comment submitted to HHS/CMS in February and June of 2017.