By the end of the 2015 open enrollment period, an estimated 11.7 million Americans had purchased a policy through a government exchange. But how does the distribution for ACA enrollment really rank nationwide?
A nationwide study conducted by the non-profit Kaiser Family Foundation (KFF) has just been released that compares the number of actual 2015 ACA/Obamacare sign-ups to the eligible population of uninsured.
This data focused on local areas, utilizing both individual ZIP codes and Public Use Microdata Areas (PUMAs). PUMAs, which each contain about 100,000 people, include the counties and census tracks within all 50 states, as well as Puerto Rico, Guam and the U.S. Virgin Islands.
Source: Kaiser Family Foundation analysis of federal marketplace signup data by zip code and modeling based on the Current Population Survey (CPS) applied to the American Community Survey (ACS). See methodology for more information.
Note: KFF defines the potential market for marketplaces as including people who were uninsured or buying their own insurance before the ACA went into effect, who are not eligible for Medicaid or employer coverage, who are not in the coverage gap, and who are citizens or authorized immigrants.
State by State Highlights
When it comes to the “potential market” of enrollees, the numbers range. For instance, Florida and Vermont had 64 and 70 percent, respectively, while less than 25 percent signed up in South and North Dakota, Iowa, Minnesota, Hawaii, and Alaska.
Individual states may experience dramatic differences within their own borders. Florida reported strong enrollment in 2015, as 64 percent of the potential market signed up for coverage, but throughout the state these numbers ranged from an estimated 100 percent in Miami to a low 21 percent in Tallahassee. Texas only reported 39 percent of potential market enrollment statewide. These results ranged from a low of 12 percent in College Station to a high of 81 percent in Houston. Impressive results were also reported in Atlanta, Philadelphia and Jackson, Mississippi. But potential market enrollment was less than 15 percent throughout parts of Ohio, Iowa and Texas.
Such factors as race and ethnicity, income and education really didn’t play strong roles in the distribution. There may be evidence that more urban areas had higher signup numbers, although this doesn’t really play a part. The researchers believe that areas with high population density and low enrollment may have experienced higher enrollment numbers. This may be due to stronger efforts and resources to get people to sign up, including those provided by local and national organizations and the federal government.
One issue regarding this potential market was that areas with very high or very low enrollment in 2014 tended to see similar patterns in 2015. For those that signed up in both 2014 and 2015, enrollment growth was high in parts of Florida, Pennsylvania and Indiana. In fact, only one area, Detroit, experienced a decrease in the share of the potential market enrolled in 2015, compared to 2014.