ACA Shows Strength as Evidenced by Steady Uninsurance Rate, CDC Numbers Show

The rate of people without health insurance was steady last year at 9.1%, with the latest CDC figures also showing that adults in Medicaid expansion states were much more likely to have health insurance than those without.

The CDC report, from the National Center for Health Statistics (NCHS), is updated quarterly but the 2017 report was of particular interest after a full year of efforts by the Trump administration to whittle away at the Affordable Care Act (ACA), including the repeal of the individual mandate penalty as part of the December 2017 tax reform legislation.

In addition, proposed regulations would expand loosely regulated short-term insurance plans, which could siphon off healthy enrollees from the ACA-regulated individual market. These changes will likely push premiums higher. The administration also cut marketing and outreach and shortened the enrollment period for ACA plans.

In 2017, 29.3 million persons of all ages were uninsured, not that much different from 2016, and 19.3 million fewer persons than reported in 2010, the CDC said.

For adults aged 18 to 64 years, 12.8% were uninsured, 19.3% had public coverage, and 69.3% had private health insurance coverage. For children aged 0 to 17 years, 5% were uninsured, 41.3% had public coverage, and 55% had private health insurance coverage.

Among adults aged 18 to 64 years, 69.3% (136.6 million) were covered by private health insurance. This includes 4.3% (8.5 million) covered by private health insurance plans obtained through the ACA’s marketplaces or state-based exchanges. The percentage of persons under age 65 with private health insurance enrolled in a high-deductible health plan increased, from 39.4% in 2016 to 43.7% in 2017.

The ACA gives states the option to expand Medicaid coverage to residents with low incomes. Last year, adults aged 18 to 64 years residing in Medicaid expansion states were less likely to be uninsured than those residing in nonexpansion states. In Medicaid expansion states, the percentage of uninsured adults fell by half, from 18.4% in 2013 (before the implementation of the ACA) to 9.1% in 2017.

In nonexpansion states, the percentage of uninsured adults decreased from 22.7% in 2013 to 17.5% in 2015. However, there was a significant increase in the percentage who were uninsured, from 17.5% in 2015 to 19% in 2017.

In March, a survey by The Commonwealth Fund found that 36% of Americans who have health coverage through the ACA and 27% of those with Medicaid are pessimistic they will be able to keep their future coverage. Nearly half cited actions by the Trump administration or Congress to undermine the ACA as the main source of their worry.

Reference

Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2017. National Center for Health Statistics website. https://www.cdc.gov/nchs/nhis/ releases.htm. Published May 22, 2018. Accessed May 22, 2018