Predictions that the health insurance exchanges would significantly shift the insurance business toward an individual market have yet to come true. In fact, the largest gains in health coverage are from increased enrollment in employer-based plans, according to a new study from Rand Corp. that was published in the journal Health Affairs.
Since 2013, 6.5 million people have signed up for an exchange plan, and about 9 million have enrolled in Medicaid through the Affordable Care Act's expanded programs. Employer-sponsored plans, meanwhile, grew by 9.6 million new enrollees.
"We don't see any evidence of a decrease in the offer of employer-based insurance," Katherine Carman, lead author and a Rand economist, said in the report. "The ACA has greatly expanded health insurance coverage in the United States with little change in the source of coverage for those who were insured before the major provisions of the law took effect."
However, it's important to note that the individual market is growing with a 46 percent increase in enrollment since last year, and that experts predict individual plans will likely continue to expand, though at a slower pace, FierceHealthPayer previously reported.
The Rand report also found that almost 26 million remain uninsured. "I think for some people [health insurance] still is expensive," Carman told CNBC. "They may be unaware of the penalties ... they may not know how much the penalties are going up next year, and some people might not think the insurance is worth it."
"We still have some people who are uninsured who have offers of insurance and are not taking it up," Carman added. "We've got people that are going to be harder to convince, for a wide variety of reasons."