Affordable Care Act, not economy, drives health insurance gains

By Annette M. Boyle

Multiple reports indicate that the sizable increase in the number of Americans with healthcare coverage is mostly a result of the Affordable Care Act, rather than an uptick in the economy, according to the Associated Press.

Republicans who promised to repeal the ACA have found many supporters in primaries, but may find the general electorate less enthusiastic about the prospect of losing health insurance. Since implementation of the ACA, 20 million Americans have gained healthcare coverage, and the proportion of those uninsured has declined to a record low of about 9 percent.

The question is whether the number of insured rose because more people received insurance through their employers as the economy bounced back or whether they obtained coverage because of the ACA.

"It's very clear that the Affordable Care Act has done most of the work in decreasing the number of uninsured," economist Robert Kaestner of the University of Illinois at Chicago told the AP.

Three recent surveys support that conclusion with varying numbers, but similar results, according to the report:

  • Employers added 3 million people to their insurance plans between 2010, when the ACA passed, and 2014, according to the Census Bureau's American Community Survey. The percentage of individuals with coverage through their employers remained the same over the four years. At the same time, the number of uninsured dropped by 10 million, mostly as a result of Medicaid expansion under the ACA.
  • The Centers for Disease Control and Prevention's National Health Interview Survey found no significant increase in employer coverage from 2010-2014, while 12.6 million more people gained health insurance.
  • There was no notable increase in the number of individuals insured by employers between 2013 and 2014, the Census Bureau's Current Population Survey found, while the number of uninsured declined by nearly 9 million.

While employer-provided plans cover 150 million to 170 million workers and their families, the percentage of Americans receiving insurance through their workplaces has steadily declined over the last decade, the AP reported.

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