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Number of Uninsured Adults Drops Sharply after ACA Implementation

New survey figures released by Gallup this week show that the number of uninsured adults dropped again in the last quarter of 2014 and is down sharply since 2013. Even as Paul Ryan and some other members of Congress argue that the Affordable Care Act is “beyond repair,” the Gallup survey data show the law has been quite successful in achieving a key objective. As the Gallup analysis concludes:

The Affordable Care Act has accomplished one of its goals: increasing the percentage of Americans who have health insurance coverage.”

According to the new Gallup findings, the portion of Americans between 18 and 64 who are uninsured declined from 21.2% in the third quarter of 2013 to 15.5% in the fourth quarter of 2014. By my calculations, that amounts to a reduction of more than 10.8 million non-elderly adults who are uninsured – a drop of about 27%.

Here are some of the other highlights of the new Gallup data:

  • The uninsured rate for adults of all ages, which peaked at 18% in the third quarter of 2013 (as shown in the graph above), declined to 13.4% a year later and to just 12.9% in the last quarter of 2014.
  • Thanks to the new insurance Marketplace and the federal subsidies for those plans, most of the growth in coverage has been among people with private, non-employer plans – which have grown from covering 16.7% of non-elderly adults in the third quarter of 2013 to 20.6% in the 4th quarter of 2014.
  • Medicaid accounts for a slower but significant portion of the rising coverage among non-elderly adults – growing 1.8 percentage points.
  • Employer coverage decreased by one percentage point (from 44.4% of non-elderly adults to 43.4%), which is a slower rate of decline than some people had expected.
  • Most of the drop in the uninsured comes among lower income adults earning less than $36,000 per year (where the uninsured rate dropped by 6.9 percentage points to 23.8% for non-elderly, low-income adults), but non-elderly adults making over $90,000 per year have also benefited, with their uninsured rate dropping from 5.8% to just 3.4%.

The decline in Wisconsin has probably been much slower than the national decrease – partly because we started out with a smaller percentage of uninsured residents than most other states, but especially because of state policy choices, such as sharply reducing BadgerCare eligibility for parents and turning down the federal funding for Medicaid expansions. The latest Gallup figures don’t include state-by-state estimates, but previous surveys have shown a much larger improvement in the insured rates in the “expansion states,” which have accepted the federal funding for expanding Medicaid eligibility for adults.

Of course, there is still considerable room for improvement nationally, and the Gallup analysis of the new data expresses optimism about a continuation in the significant growth in the number and percentage of Americans with insurance – citing the following considerations:

  • Prior to the current open enrollment period, Gallup found that more than half of uninsured adults said they planned to sign up for coverage.
  • The employer mandate is expected to boost coverage, as is the gradual increase in tax penalties for individuals who are uninsured.
  • Additional states are beginning to implement or planning to implement Medicaid expansions.

After getting off to a rocky start in the fall of 2013, the Affordable Care Act has been delivering on the promise of making a very large dent in the number and percentage of uninsured Americans. In light of that progress, as well as many other very important benefits of the ACA, it would be a huge step backwards to scrap this law, as some members of Congress have recommended.



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WI Budget Project

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