Drum roll, please


Like a telethon tote board that keeps racking up numbers while the timpani play a suspense-inducing roll in the background, reports on the number of Americans who obtained coverage under the Affordable Care Act (ACA) keep inching that final number upward.

The most recent number? (Cue the timpani.) Nine-and-a-half million people obtained coverage, according to the Commonwealth Fund and reported in USA Today.

However, analysts from the Rand Corporation estimate that 14.5 million people gained coverage but 5 million were uninsured previously and lost coverage because of the health care law. So the net gain is around 9 million.

What isn’t certain is how many were left without coverage when the federal government was unable to resolve what it called inconsistencies in reporting and verifying information such as citizenship and annual income in order to determine eligibility for subsidies. The Department of Health and Human Services is still sorting this out.

The Commonwealth Fund further states that when you count into the mix all the health insurance expansions initiated by the Affordable Care Act (ACA), an estimated 20 million Americans have gained coverage as of May 1. These include young adults who gained coverage under their parents’ policies, people who bought plans in the marketplaces, individuals who purchased coverage directly from insurers, and adults and children who enrolled in Medicaid or the Children’s Health Insurance Program (CHIP).

The largest gains in coverage were experienced by young adults ages 19 to 34, whose uninsured rate fell from 28 percent to 18 percent; Latinos, whose rate declined from 36 percent to 23 percent; and low-income adults, whose rate dropped from 35 percent to 24 percent. This is according to the Commonwealth Fund.

In states that expanded eligibility for Medicaid, uninsured rates among low-income adults fell substantially. But in states that did not expand Medicaid, uninsured rates for people under the poverty level remained largely unchanged; these rates were double those of states that expanded. A large portion (42%) of new Medicaid enrollees were young adults 19 to 34. This was the largest share of any adult age group.

Sixty-three percent of adults with new coverage through the marketplaces or Medicaid had been uninsured previously.

Where might these numbers be headed in the future? The Congressional Budget Office (CBO) estimates that 5 million people will purchase coverage directly from an insurer this year. The CBO projects that new enrollment in Medicaid and CHIP will reach 7 million in 2014 and 13 million eventually.

Meanwhile, the number of uninsured Americans is predicted to continue its downward turn. The CBO projects that the law will decrease the number of uninsured by 12 million this year and by 26 million by 2017.

But more work is needed in order to get more people enrolled in coverage, according to the Commonwealth Fund. Millions of the nation’s poorest adults in states that have not yet expanded Medicaid eligibility still lack access to health insurance coverage. Those who are uninsured and those at the lowest income levels are least likely to be aware of their coverage options under the law.


Susan Rupe is assistant editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Connect with Susan →

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