UPDATE (7/10/2015): New Gallup Results released today show a continued massive drop in the number of uninsured Americans.
ORIGINAL ARTICLE (5/12/2015): According to a Gallup poll conducted between Jan. 2 and March 31 of this year, the number of uninsured adults in the U.S dropped to 11.9 percent in the first quarter of 2015. This represents a 1-point drop since the final quarter of 2014 and an overall decline of 2.7 percent since Gallup first started tracking the uninsured rate back in 2008.
While 2.7 percentage points may not seem significant, it’s important to note the upward trend in the number of uninsured Americans in the period spanning from 2008 to present. During that time, the rate of people living without insurance climbed steadily to a peak of 18 percent at the end of 2013. Since fall 2013, which is when the ACA marketplaces opened for the first time, the rate has decreased drastically. Now, less than 12 percent of the American adult population remains uninsured.
A Targeted Audience
The ACA was designed to grant access to health insurance to all Americans, but the law’s creators have been specifically targeting certain demographics in recent advertisement efforts nationwide. Those include Hispanics, black Americans, low-income families and young people. These demographics represent people who are more likely to lack coverage. Traditionally and today, the Hispanic population in particular is less likely to sign up for health insurance.
In 2013, nearly 39 percent of Hispanics lacked insurance. As of the end of the first quarter in 2015, about 30 percent remain uninsured. The decline by more than 8 points suggests that the government’s advertising efforts are paying off in some ways, but there is still a long way to go in making sure that underrepresented populations get the health insurance that they need.
The demographic that has most benefited from the new healthcare law seems to be the population that the ACA was designed to serve. Low-income families have long been denied access to healthcare simply due to cost. Affordable private plans on the marketplaces and the expansion of Medicaid have helped reduce the number of uninsured poor. According to the Gallup survey, the number of uninsured families that earn less than $36,000 annually dropped from 30.7 percent in 2013 to just 22 percent this spring.
The Impact of Medicaid Expansion
Federal and state marketplaces helped millions of individuals and families throughout the country sign up for health insurance for the first time, but the newly created exchanges can’t take all of the credit for insuring America. Medicaid has played a huge role in helping families gain coverage. Under the ACA, Medicaid was expanded to cover people who earn up to 138 percent of the federal poverty limit. The Supreme Court ruled in 2012 that states could opt out of expansion. While 29 states and the District of Columbia have chosen to expand their Medicaid programs, the remaining states have yet to decide or have chosen to maintain their existing programs.
In states that did expand Medicaid, it’s estimated that about 6.5 million people have gained insurance over the past two years thanks to the new guidelines. The Gallup survey revealed that Medicaid participation is up 2.1 percent since the end of 2013. Medicaid accounts for 9 percent of the insured population among adults aged 18 to 64.
Challenges to the Uninsured Rate
Despite promising numbers in the recent Gallup poll, the government still has work to do in making sure that the ACA works effectively for the long term. The Supreme Court will decide the fate of federal tax subsidies in June based on a case being brought against the language of the law. In this case, plaintiffs argue that residents in states without a state-run health exchange should not be eligible for tax credits to help pay for premiums on the marketplace. If the court rules in their favor, then millions of Americans would lose access to affordable health insurance.
Another challenge centers on Medicaid expansion in states that have opted to keep existing programs in place. Montana recently created an alternative solution to allow Medicaid expansion under certain conditions, but it remains to be seen whether the federal government will agree to their stipulations based on the terms of the ACA.
The Gallup survey looks at numbers through the end of the first quarter, but there may be another drop in the uninsured rate due to the extended sign-up period enacted by the government during tax season. Gallup notes that a recovering economy and job growth may have contributed to the increased number of insured Americans since 2008. The ACA has had its fair share of challenges over the past five years, but the uninsured rate continues to drop despite setbacks and legal challenges.