Analysis: 9.3M People Obtained Health Coverage Since Sept. 2013
Between September 2013 and mid-March 2014, an estimated 9.3 million U.S. residents gained health coverage under the Affordable Care Act, according to a new analysis by RAND, Modern Healthcare's "Vital Signs" reports (Dickson, "Vital Signs," Modern Healthcare, 4/8).
The data were gleaned from monthly surveys that RAND has conducted since November 2013 about insurance choices and public opinion, and a separate September 2013 survey about insurance choices. The new analysis includes responses from 2,425 adults ages 18 to 64 who participated in the two surveys (Carman/Eibner, The RAND Blog, 4/8).
Researchers noted that their analysis was based on a small sample of the entire population, which means that the margin of error is "relatively large." They also noted that the final survey used for the analysis was conducted before the enrollment surge in the ACA's insurance exchanges in the final half of March, suggesting that the number of insured individuals has potentially increased since then (Easley, "Healthwatch," The Hill, 4/8).
Analysis Details
For their analysis, researchers took into account:
- Individuals who signed up for coverage through the exchanges beginning in October 2013;
- Individuals who purchased plans directly from insurers;
- Individuals who became eligible for Medicaid under the ACA; and
- Individuals who lost coverage in 2013.
According to the Los Angeles Times' "Politics Now," researchers deduced that at least 14.5 million previously uninsured adults gained coverage in 2013 through mid-March. However, about 5.2 million of them lost it or gave up the coverage. Most of those who gave up or lost coverage had health plans through an employer; fewer than one million had purchased their insurance on the individual market.
The net coverage gain was about 9.3 million, according to the RAND report (Lauter, "Politics Now," Los Angeles Times, 4/8). Meanwhile, the national uninsured rate declined from 20.5% to 15.8% between September and mid-March, researchers said.
The analysis also found that about 1.4 million of the 3.9 million who enrolled in an exchange plan by mid-March were previously uninsured ("Vital Signs," Modern Healthcare, 4/8).
Meanwhile, the analysis counters predictions by supporters and opponents of the ACA, who suggested that employer-sponsored coverage rates would decline under the law, according to "Politics Now" ("Politics Now," Los Angeles Times, 4/8). The analysis found that the bulk of newly insured individuals -- about 8.2 million -- had employer-sponsored insurance ("Healthwatch," The Hill, 4/8).
Overall, RAND found that the ACA did not affect coverage choices for the majority of insured U.S. residents, as 80% of study and survey participants reported having the same type of coverage in March 2014 and in September 2013 ("Vital Signs," Modern Healthcare, 4/8).
Findings Align With Other Recent Analyses
According to "Politics Now," the RAND findings appear to align with other recent analyses on enrollment and coverage trends ("Politics Now," Los Angeles Times, 4/8).
Last month, the Los Angeles Times reported that at least 9.5 million previously uninsured U.S. residents gained coverage under the ACA during the initial open enrollment period for the exchanges. The analysis was based on various national surveys and enrollment data (California Healthline, 3/31).
Earlier this month, a study by the Urban Institute's Health Policy Center reported that as many as 5.4 million previously uninsured residents gained coverage since the federal and state insurance exchanges were launched in October 2013 (California Healthline, 4/4).
Last week, a Gallup-Healthways Well-Being Index survey found that the uninsured rate had fallen to its lowest since 2008, with 14.7% of adults lacking coverage in the last half of March (California Healthline, 4/7).
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