Affordable Care Act provisions, including marketplace coverage and Medicaid expansion, have led 20 million U.S. adults to gain health insurance from 2010 to early 2016, the Department of Health and Human Services (HHS) announced.
HHS reached this estimate, which it calls a "historic reduction in the uninsured," by analyzing data from the Gallup-Healthways Well-Being Index through Feb. 22, controlling for general economic conditions, pre-existing trends, geographic location and demographic changes. Here's a sampling of the full report's findings:
- Among Americans ages 19-25, 6.1 million have gained coverage because of the ACA--2.3 million of them between 2010 and 2013 through the provision that allowed individuals younger than 26 to remain on a parent's coverage.
- The uninsured rate among black non-Hispanics and white non-Hispanics each dropped by more than 50 percent, while the uninsured rate of Hispanics dropped by more than 25 percent.
- Women experienced a greater decline in uninsured rates than men--a 49.9 percent decline compared to a 37.9 percent decline, respectively.
The Centers for Disease Control and Prevention's National Health Interview Survey estimated that 9 percent of the overall U.S. population--including those older than 64 and younger than 18--are uninsured. Because HHS' report was limited to coverage gains for Americans ages 18-64 tied to the ACA, it estimates that 11.5 percent of nonelderly adults are uninsured.
Enrollment in ACA marketplace plans, meanwhile, is likely to be in line with HHS' end-of-year target of 10 million enrollees, according to a new analysis from the Kaiser Family Foundation.
That figure is lower than the Congressional Budget Office's adjusted estimate of 13 million by the end of 2016, the analysis points out--likely because of a less-than-expected decline in employer-based coverage, the fact that many are still buying individual coverage outside of the marketplaces, and the challenges associated with affordability of coverage.
In terms of future marketplace enrollment growth, the analysis says that if all U.S. states improved to at least the average of the 10 best-performing states in the next several years, total enrollment could reach 16.3 million. Given the typical rate of attrition, that would translate to an "effectuated" marketplace enrollment of 14.7 million.
Even so, "absent a substantial boost in outreach or changes to the subsidies to make insurance more affordable, substantial increases in marketplace enrollment are unlikely," KFF says.
Number of uninsured Americans at all-time low
Number of uninsured Americans dropped by nearly 16 million since 2013
Medicaid expansion, state exchanges drive greater drops in uninsured
HHS aims for 10M marketplace enrollees by end of 2016
Open enrollment sign-ups total 12.7 million
CBO lowers estimate for Affordable Care Act enrollment