Insurance coverage rates increase after rollout of Affordable Care Act

The Affordable Care Act has led to a continued increase in insurance coverage since initiation, with an estimated 22.8 million people newly insured as of February 2015, according to recent data from the RAND Corporation.

There were 5.9 million people that lost coverage during this time, correlating to a net increase of 16.9 million people with insurance.

“The net increase that we observed is slightly higher than a recent estimate from the federal government, which found 14.1 million newly insured adults since 2013,” Katherine G. Carman, economist with the RAND Corporation, Santa Monica, Calif., and colleagues wrote. “Employer coverage is by far the largest source of insurance among Americans younger than age 65, and the [Affordable Care Act] creates new incentives for people to take up employer policies.”   

The researchers sought to assess the changes in insurance coverage after the second enrollment period of the Affordable Care Act through February 2015.

Longitudinal data were pooled on insurance transitions from the RAND Health Reform Opinion Study for adults aged 18 to 64 years. The researchers observed a consistent increase in insurance coverage from November 2013 to May 2014, with the most growth occurring in April and May 2014.

Between September 2013 and February 2015, Medicaid enrollment increased by 9.6 million; enrollment in Marketplace plans increased by 11.2 million; and employer-sponsored insurance plans increased by 8 million.

“The Medicaid increases were driven by both people becoming newly insured and people switching from one type of insurance to another,” Carmen and colleagues wrote. “Coverage through non-group policies declined by 1.9 million and other sources by 10 million. Those losing coverage became uninsured or switched to another type of plan.”

The researchers observed a decrease in the number of uninsured people from 42.7 million in September 2013 to 25.8 million in February 2015.

While 5.9 million people lost insurance out of the 155.8 million people who were insured in 2013, the number of those who gained insurance coverage was three-fold higher as the number of people losing coverage.

Of those who gained insurance coverage, 9.6 million enrolled in employer plans. This was followed by 6.5 million who enrolled in Medicaid, 4.1 million who enrolled in Marketplace plans, 1.5 million in other insurance sources and 1.2 million in nongroup plans.

While there were concerns regarding insurance plan cancellations, only 600,000 people with nongroup coverage became uninsured during the study period. Eighty-percent of the 155.8 million people with insurance as of September 2013 underwent no changes in the source of their care plans.

“While these data have limitations, especially due to the low response rate, they provide an early look at how the [Affordable Care Act] has affected insurance enrollment,” the researchers wrote.

Disclosures:  The researchers report receiving an investment from the RAND Corporation’s Internal Research funds.