Obamacare: What Are the Numbers?
One year into the
implementation of many of the Affordable Care Act’s key features- including
Medicaid expansion and the opening of the health insurance exchanges, numbers
are coming in regarding new insurance enrollments in the past year. The numbers are
based off of two surveys reported in September, 2014: the Centers for Disease
Control National Health Interview Survey and the Census Bureau’s Current
Population Survey. The Current Population Survey only gave the estimated
percentage of uninsured people in 2013 (13.4% or 42 million Americans). On the
other hand, The National
Health Interview Survey gave the estimated number of uninsured people for
both 2013 and 2014 and compared the two figures. A preliminary report with
figures from January to March 2014 estimates that in 2014 there are 3.8 million
fewer uninsured people than in 2013.
However, more
concrete numbers were provided by the Heritage
Foundation on October 22. The Heritage Foundation found that insurance
enrollment in individual market plans increased by 6,254,564 individuals and
that Medicaid enrollment increased by 6,072,651 individuals. This seemingly
large increase in insurance coverage is marked, but still not up to the
government’s predictions for 2014. The increase in insurance coverage, however,
is not as great as first glance indicates. Although there was an increased
enrollment in individual market plans of over six million individuals (both on
and off exchanges), there was simultaneously a decline of 3,788,978 individuals
enrolled in employer-sponsored group plans. Hence the net individual market
plan enrollment is only 2,465,586 individuals.
1- The changing number of uninsured in 2014
It is interesting
to note that there was an enormous increase in the number of new Medicaid
enrollments. 26 states and Washington, D.C. have chosen to implement expanded
Medicaid programs in 2014. Of over six million new Medicaid enrollments in
2014, 94% occurred in states that implemented Medicaid expansion. It will be
interesting to see if this trend continues. In 2015, Pennsylvania will
implement expanded Medicaid, opening it up to those making up to 138% of the
Federal Poverty Level. Perhaps in future years, more states will join the
bandwagon and expand their Medicaid programs and begin to reduce inequality.
For reduction of
inequality is what the Affordable Care Act is- theoretically- all about. The
enrollment patterns in 2014 are reflective of that goal. The Medicaid expansion
in 26 states and Washington, D.C. has evidently allowed many insurance who
could not afford private insurance plans. Many of the new enrollments are of
people who are traditionally underprivileged- those living in rural areas;
young people (defined as 18-34); and certain racial groups, such as black and
Hispanic individuals; and women.
2- Uninsured rates in 2014 by County
Moving forward, it
will be interesting to see whether the number of uninsured will continue to
decline, and whether more states will expand Medicaid. As the Open Enrollment
Period for individual market plans will begin on November 15, there is concern
about technological issues such as occurred last year. There is also concern
that people may not enroll for health insurance due to higher premiums. In light of 2014’s only moderate success in increased
enrollment and the deterrents from obtaining health insurance, the Department
of Health and Human Services (HHS) has modified its 2015 predictions.
Abandoning the 13 million figure, the HHS now predicts that 9-9.9 million will
newly obtain health insurance in 2015.
Until next time,
Andrew Herman
AH Insurance Services, Inc.
