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===Coverage=== {{Further|Health insurance coverage in the United States}} The American system is a mix of public and private insurance. The government provides insurance coverage for approximately 53 million elderly via [[Medicare (United States)|Medicare]], 62 million lower-income persons via [[Medicaid]], and 15 million military veterans via the [[Veteran's Administration]]. About 178 million employed by companies receive subsidized health insurance through their employer, while 52 million other persons directly purchase insurance either via the subsidized marketplace exchanges developed as part of the [[Affordable Care Act]] or directly from insurers. The private sector delivers healthcare services, with the exception of the Veteran's Administration, where doctors are employed by the government.<ref name="Census2016">{{cite web|url=https://www.census.gov/library/publications/2017/demo/p60-260.html|title=Health Insurance Coverage in the United States: 2016|website=census.gov}}</ref> Multiple surveys indicate the number of uninsured fell between 2013 and 2016 due to expanded [[Medicaid]] eligibility and health insurance exchanges established due to the [[Patient Protection and Affordable Care Act]], also known as the "ACA" or "Obamacare". According to the [[United States Census Bureau]], in 2012 there were 45.6 million people in the US (14.8% of the under-65 population) who were without health insurance. This figure fell by 18.3 million (40%) to 27.3 million (8.6% of the under-65 population) by 2016.<ref name="Census_HistTable">{{cite web|url=https://www.census.gov/data/tables/time-series/demo/health-insurance/historical-series/hic.html|title=Health Insurance Historical Tables βHIC Series|publisher=Census}}</ref> However, under President Trump these gains in healthcare coverage have begun to reverse. The [[Commonwealth Fund]] estimated in May 2018 that the number of uninsured increased by four million from early 2016 to early 2018. The rate of those uninsured increased from 12.7% in 2016 to 15.5%. The impact was greater among lower-income adults, who had a higher uninsured rate than higher-income adults. Regionally, the South and West had higher uninsured rates than the North and East. Further, those 18 states that have not expanded Medicaid had a higher uninsured rate than those that did.<ref>{{cite journal |url=http://www.commonwealthfund.org/publications/blog/2018/apr/health-coverage-erosion |title=Commonwealth Fund β First Look at Health Insurance Coverage in 2018 Finds ACA Gains Beginning to Reverse |year=2018 |doi=10.26099/aacp-5268 |last1=Collins |first1=Sara R. |last2=Gunja |first2=Munira Z. |last3=Doty |first3=Michelle M. |last4=Bhupal |first4=Herman K. |publisher=Commonwealth Fund}}</ref> According to [[Physicians for a National Health Program]], this lack of insurance causes roughly 48,000 unnecessary deaths per year.<ref name=uninsureddeaths>{{cite web |last= Woolhandler |first= S. |date= September 12, 2012 |title= Despite slight drop in uninsured, last year's figure points to 48,000 preventable deaths |publisher= Physicians for a National Health Program |url= http://www.pnhp.org/news/2012/september/despite-slight-drop-in-uninsured-last-year%E2%80%99s-figure-points-to-48000-preventable- |access-date= September 26, 2012 |display-authors= etal |archive-url= https://web.archive.org/web/20120924021844/http://www.pnhp.org/news/2012/september/despite-slight-drop-in-uninsured-last-year%E2%80%99s-figure-points-to-48000-preventable- |archive-date=September 24, 2012 |url-status=dead}}</ref> The group's methodology has been criticized by [[John C. Goodman]] for not looking at cause of death or tracking insurance status changes over time, including the time of death.<ref>{{cite journal|last=Goodman|first=John|title=Does Lack Of Insurance Cause Premature Death?|journal=Health Affairs Forefront |url=https://www.healthaffairs.org/do/10.1377/forefront.20090921.002196|publisher=Health Affairs|date=September 21, 2009|doi=10.1377/forefront.20090921.002196}}</ref> A 2009 study by former [[Bill Clinton|Clinton]] policy adviser Richard Kronick found no increased mortality from being uninsured after certain risk factors were controlled for.<ref>{{cite journal|last1=Kronick|first1=Richard|title=Health Insurance Coverage and Mortality Revisited|journal=Health Services Research|date=August 2009|volume=44|issue=4|pages=1211β31|doi=10.1111/j.1475-6773.2009.00973.x|pmid=19453392|pmc=2739025}}<!--|access-date=August 15, 2014--></ref>
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