More than 1 million people have lost health coverage since 2016, a trend that is due in part to a substantial decline in the number of people buying off-exchange plans, according to the latest data from the Congressional Budget Office.
The CBO released (PDF) its latest analysis of coverage for people under the age of 65 late last week and found that number of uninsured Americans increased from 27.5 million in 2016 to 28.9 million in 2018.
Part of this trend is a notable decrease in people buying individual market insurance outside of the federal and state Affordable Care Act exchanges, CBO found. In 2016, 7.4 million bought such coverage, while just 4.9 million did so in 2018.
In addition, CBO found that the number of people buying unsubsidized plans on the exchanges decreased in that same window. About 1.6 million bought such plans in 2016, compared to 1.3 million in 2018.
CBO attributes both trends to rising premiums.
CBO’s report joins several released of late that indicate the uninsured rate has been on the rise over the past several years. A Gallup poll, released in January, found that the rate has reached 13.7% nationwide, the highest mark in four years.
Gallup also noted that rising premiums were a likely factor, alongside steps taken early in the Trump administration that introduced uncertainty in the markets, such a pledge to fully repeal the ACA.
CBO also said in a blog post that it updated its methodology for calculating its uninsured estimates ahead of its annual baseline budget projections. The group will now include employer and consumer preference data in estimating how legislation may impact coverage rates.
The update, CBO Director Keith Hall wrote in the post, will allow the organization to provide more detailed analyses.
"The new model better captures underlying relationships among individuals, families, employment, income and insurance coverage because it incorporates new data and includes refinements in modeling insurance choices,” Hall wrote.