Perino asks, “How did we suddenly get to 54 million uninsured?”

Perino used apples-to-oranges comparison to cast doubt on whether bill will reduce uninsured by 31 million. On the December 21 edition of Fox & Friends, Perino said, "[T]hey keep saying that 31 million people are going to be insured under this bill. But in the CBO report, it says 23 million will remain uninsured." She added, “So, I don't know, how did we suddenly get to 54 million uninsured? I thought we were at 30 million uninsured. It's just so convoluted, and it's the reason that America has very little confidence in this bill.”

CBO confirms: Uninsured would increase to 54 million by 2019 under do-nothing scenario

CBO indeed estimated that under current law, 54 million would be uninsured by 2019. In a chart included in a December 19 analysis of the manager's amendment to the Senate health care bill, CBO said that under current law, 54 million nonelderly people would be uninsured by 2019:

Perino's “30 million” uninsured figure is for 2008 and excludes undocumented immigrants and others with access to public insurance. By saying, “I thought we were at 30 million uninsured,” Perino falsely suggested that the “30 million” figure contradicted CBO's estimate that under current law, there would be 54 million uninsured people in 2019 -- a comparison she used to cast doubt on reports that the Senate legislation would reduce the number of uninsured by 31 million people. But this is an apples-to-oranges comparison. The 30 million figure that Perino cited refers to the number of uninsured in 2008 after subtracting undocumented immigrants, as well those already eligible for but not enrolled in public insurance programs. Following Obama's September 9 address to a joint session of Congress -- during which Obama said that "[t]here are now more than 30 million American citizens who cannot get coverage" -- Office of Management and Budget director Peter Orszag wrote in a September 10 blog post:

Today, the Bureau of the Census released the most recent data on the number of uninsured Americans. The report, Income, Poverty, and Health Insurance Coverage in the United States: 2008, reveals that 46 million people were uninsured in 2008, the last year for which there are data. These data are based on the Current Population Survey. With two different numbers, there has been some confusion as to which is accurate. Well, both are -- and the President's version is more focused on the relevant target population for health reform since it excludes unauthorized immigrants.

The Census report indicates that of the 46 million uninsured individuals, 34 million were native born and 2.8 million were naturalized citizens. The report thus shows that there were 36.8 million uninsured U.S. citizens (native born and naturalized) in 2008. An alternative calculation includes legal immigrants, which based on a figure from the Pew Hispanic Center would bring the total to something like 39 million.

Some ambiguity surrounds how to treat individuals who are already eligible for public insurance programs like Medicaid and S-CHIP but do not enroll in those programs, which estimates from the Kaiser Commission on Medicaid and the Uninsured suggest may amount to millions of individuals. These individuals are uninsured but some interpretations would suggest they should not be counted among those who “cannot get” coverage. Subtracting them from the total would produce a number closer to 30 million.

To be conservative, the President thus stated that “more than 30 million American citizens” cannot get coverage.

CBO confirms: Senate bill would reduce number of uninsured by 31 million by end of 2019

Elmendorf: Number of uninsured “would be reduced by about 31 million” by 2019 under Senate health care bill. CBO director Douglas Elmendorf wrote in the December 19 analysis that under the Senate health care bill, "[b]y 2019, CBO and [the Joint Committee on Taxation] estimate, the number of nonelderly people who are uninsured would be reduced by about 31 million, leaving about 23 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants)."