Uninsured Rate Goes Down, Largely Due to Obamacare


The number of people without health insurance decreased by 1.3 percent between 2014 and 2015, according to a new report released Tuesday by the Census Bureau.

In 2015, 9.1 percent of the population, or 29 million people, was uninsured. This was down from 10.4 percent, or 33 million people, in 2014. The coverage gains occurred among the private insurance market, largely attributable to Obamacare, and government coverage like Medicaid or Medicare. While other surveys have shown similar numbers, the Census Bureau report has a large sample size and is regarded as highly reliable.

The Obama administration touted the increased health coverage as a result of “continued progress under the Affordable Care Act,” in a statement by senior White House officials. The uninsured rate has fallen in every state and the District of Columbia since 2013, before Obamacare’s major provisions took effect.

The officials — Jason Furman, chairman of the Council of Economic Advisors, Sandra Black, a member of the council, and Matt Fielder, the council’s chief economist — said in the statement that states who have not taken Obamacare’s Medicaid expansion should do so to further reduce their uninsured rates.

“While all states have seen increases in insurance coverage since the ACA’s major coverage provisions took effect in the beginning of 2014, the extent of those gains have varied widely by state,” the officials wrote. “Notably, states that have expanded Medicaid under the ACA have seen larger coverage gains on average, particularly if they started with a larger uninsured population.”

The White House said if non-expansion states had seen coverage gains comparable to those in expansion states, the uninsured rate in those states would have been almost 3 percentage points lower in 2015.

The coverage gains in 2015 reinforce the idea that the second year of implementation of major Obamacare provisions continued to advance coverage.

“It’s just notable to see that even in the second year of the ACA, we’re continuing to see large gains in coverage. The first year obviously had very large gains in coverage as the provisions of the law took effect,” said Rachel Garfield, an associate director at the Kaiser Family Foundation. “I think some people were wondering if the levels would sort of plateau or we would continue to see coverage gains.”

News of a lower uninsured rate comes in the midst of turmoil on ACA exchanges as the 2017 open enrollment season approaches. As the White House highlights the positive effects of the health care law, Republicans on Capitol Hill have seized on double-digit premium increases in 2017 and insurer pullouts on exchanges as evidence that the law isn’t working.

“Unfortunately when Congress and Washington make a mistake, it’s the American people that have to pay the price, and it seems like the consequences of Obamacare are only getting worse,” said Senate Majority Whip John Cornyn (R-Texas) in a floor speech Tuesday.

The data released on Tuesday predates announcements of insurer pullouts. The Obama administration has been adamant the large premium increases in 2017 are a one-time phenomenon.

Issues of coverage and competition or affordability can also, in a sense, be separated. While it’s possible coverage will drop if plan options aren’t available or consumers can’t afford the coverage that is available, this hasn’t happened yet.

“While those stories of insurer pullouts made a lot of news, they may not have affected that many people. In most of those markets there was still an affordable coverage option for people,” Garfield said. “People haven’t lost coverage because of those announcements.”

The greatest change in coverage between 2014 and 2015 was in the individual insurance market, which saw an increase in coverage of 1.7 percentage points and covered 16.3 percent of people. This was up from 14.6 percent in 2014.

Notably, the rate of coverage in the employer market stayed nearly the same from 2013 to 2015. This confirms the notion that, contrary to predictions ahead of the ACA’s implementation, there has not been a large shift from employer-based coverage to the individual market.

The data for 2015 also found noticeable differences in health coverage by race. Whites had the lowest uninsured rate, at 6.7 percent, while Hispanics had the highest uninsured rate, at 16.2 percent. Hispanics also had the highest increase in coverage between 2014 and 2015, at 3.6 percentage points.

Morning Consult