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From Health Law Daily, April 14, 2015

Uninsured rate dips, especially for those with lower incomes

By Kayla R. Bryant, J.D.

According to a Gallup report, the rate of U.S. adults without health insurance dropped to 11.9 percent in the first quarter of 2015. This is the lowest uninsured rate since Gallup began tracking in 2008. Since the end of 2013, the uninsured rate among households making less than $36,000 per year has dropped 8.7 percent. Hispanics had the highest uninsured population of subgroups prior to the implementation of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), but significant headway has been made as the rate of uninsured Hispanics has dropped 8.3 percent. Despite these gains, these groups still have higher uninsured rates than other categories.

Findings. As part of the Gallup-Healthways Well-Being Index, 500 adults per day were asked if they had health insurance from January 2 to March 31, 2015. The 11.9 percent rate marks a decline of 1 percent from the last quarter of 2014. In early 2008, the uninsured rate was around 14 percent; it rose to over 17 percent in 2011, and peaked at 18 percent in 2013. Since the individual mandate in section 5000A of the ACA, which requires most Americans to have insurance or face a penalty, went into effect at the beginning of 2014, the uninsured rate has taken its sharpest decline. The report noted that the uninsured rate is lower than before the recession began, and indicated that the decline is not only related to an improving economy.

Of those under 65, an additional 3.5 percent stated that they have a self-funded plan than in the fourth quarter of 2013. The report indicated that this is probably a result of additional purchases through a Health Insurance Exchange. However, due to many states expanding Medicaid with the help of federal funding through ACA provisions, the percentage of 18- to 64-year olds covered by Medicaid has increased to 9 percent since the individual mandate took effect.

Implications. The second open enrollment period ended on February 15. However, the federal Exchange and some state Exchanges announced some special enrollment periods through the end of tax season and beyond. The report pointed out that plans purchased in April will take effect in May, which could further drive down the uninsured rate. These special enrollment periods were created as an opportunity for new customers to purchase coverage after realizing the effects of the individual mandate on their tax returns.

Subsidies. Although the application of the individual mandate may cause more people to purchase insurance, a future Supreme Court ruling in King v. Burwell may result in an increase in the uninsured rate. Many people are able to afford insurance on the Exchanges due to the receipt of tax credits. Credits received for insurance purchased on the federal Exchange may be in jeopardy, because the petitioners in that case argue that the ACA only provides tax credits for individuals that receive coverage through state Exchanges, pursuant to section 1311 of the ACA. If these credits are not available for those individuals receiving coverage on the federal Exchange, an estimated 8 million or more may lose insurance coverage (see High costs and low enrollment could push health insurance market out of balance without federal subsidies, January 14, 2015).

Companies: Gallup

MainStory: TopStory HealthCareReformNews CMSNews MedicaidNews

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