How Successful is the ACA Really at Cutting Uninsured Rates?
“The only thing that seems to be consistent is that the number of uninsureds has dropped, but ... it is difficult to say that the total change is only due to the ACA.”
By - Misunderstandings swirl as the Affordable Care Act’s (ACA) ever evolving ability to reduce the number of uninsured adults is continuously called into question.
The total number of adults who have acquired health insurance coverage following implementation of the ACA is quite tangibly on the up and up, says a 2015 WalletHub report.
Over 10.6 million more people have acquired health insurance coverage compared to pre-ACA reports, confirms WalletHub’s national figures from 50 states and the District of Columbia.
The current uninsured rate has reportedly fallen nationwide to 11.7 percent compared to the pre-ACA rate of 15.5 percent.
Highlights of various states' post-ACA uninsured rates
Massachusetts is the state with the lowest uninsured rate for 2014 at over 3 percent, says WalletHub. Compared to 2010, this decrease means nearly 67,000 more Massachusetts residents have acquired health insurance coverage since ACA implementation.
On the flip side, Oklahoma tops the list for having the highest uninsured rate compared to the rest of the nation.
Texas reportedly has the largest absolute gap in uninsured rates between low-income and high-income households at 20 percent.
Nevada reportedly saw the largest drop of uninsured children between 2010 and 2014 at a rate of over 7 percent.
Regarding numbers on race and health insurance percentages, an over 26 percent gap is reported for differing uninsured rates between Hispanics and whites, the latter ranked higher by WalletHub.
New Mexico is the state with the highest reported rate of publicly insured individuals – at over 44 percent.
Regarding Medicaid expansion and states’ uninsured rates, the average reported rates for those states that expanded Medicaid is over 9 percent. For those states that did not expand Medicaid, the average reported rate is over 12 percent.
Professors weigh in on ACA’s greater impact on uninsured
In light of the aforementioned data, to what extent is the ACA essentially triumphing in slashing the number of uninsured adults? To help answer this question, WalletHub asked a variety of professors to elaborate upon their opinions.
Says John Large, Assistant Professor of Health Policy and Management at the University of South Florida, College of Public Health, “The only thing that seems to be consistent is that the number of uninsureds has dropped, but only with 2 years of data, it is difficult to say that the total change is only due to the ACA.” The overall impact the ACA has had thus far has been “positive,” he maintains.
According to Randall P. Ellis, Professor of Economics at Boston University, “[The ACA] has significantly reduced the number of uninsured in the US, particularly among young adults age 20-25, who were immediately eligible to be covered under their parents’ policy. More recently, it has been successful at increasing coverage for the employed uninsured.”
Ellis says it would have been especially beneficial if more states had not opted to expand Medicaid coverage, as such “creates great inequities across states."
“Even in Europe[,] coverage is only 99 (sic) due to people moving around and choosing not to register, but eventually, if all of the features of the act were enforced, it would achieve that level of coverage. Massachusetts has coverage that is about 98%,” states Ellis.
Lastly, according to Laura D. Hermer, Professor of Law at Hamline University School of Law, the ACA has thus far successfully cut the number of uninsured adults. More Americans will acquire coverage as the ACA evolves, she says, especially as the penalty for failing to have coverage gains prominence.
“Before the ACA’s biggest health insurance provisions went into effect in 2014, approximately 20% of nonelderly American adults lacked health insurance coverage,” she says.
“That number now stands at nearly 13%, only a year and a half later. Yet the uninsured rate would have dropped even further, if all states had instituted not only the ACA’s private market provisions, but also its Medicaid expansion,” Hermer claims.
The alleged extent of the ACA's impact on the uninsured, nonetheless, continues to hold substantial weight among mass media outlets, especially as the next year of presidential debate activity unfolds among households both large and small.
