Health & Human Services

5.4 or 9.5 Million Newly Insured Because of Obamacare?

Two recent reports give early estimates for how many people were uninsured before signing up for coverage under the Affordable Care Act. They offer different totals, but not because they disagree.
by | April 4, 2014
President Obama listens as he has lunch with five young people who are spearheading creative outreach efforts to help enroll young consumers through the online insurance marketplaces in Washington, D.
President Obama listens as he has lunch with five young people who are spearheading creative outreach efforts to help enroll young consumers through the online insurance marketplaces in Washington, D.C. AP/Susan Walsh

Two recent reports on the number of people who were uninsured before selecting plans through the Affordable Care Act appear to be at odds, but one just casts a wider net in its measurements.

The Urban Institute published a report yesterday arguing that about 5.4 million people were previously uninsured, but the Washington, D.C. think tank added that its estimate understates the full number for a couple reasons. When considering the number of young adults who joined their parents' plans (an early ACA provision) and people who gained coverage from Medicaid in states that adopted expansion early or gained coverage from other early parts of the law, the rough total edges closer to the 9.5 million number cited by the Los Angeles Times in an article, which relied on several sources.

Critics of the new health law have long questioned the number of people who were actually gaining coverage as opposed to signing up because they were forced to leave plans that didn’t meet the law’s standards. The health exchanges allow people to shop for private insurance plans at subsidized rates, depending on their income, or to sign up for Medicaid if they qualify. The federal government runs the marketplaces for 36 states. The other 14 host their own.

The Urban Institute has been tracking rates of the uninsured by state since early 2013, when some 47 million Americans lacked insurance. Its figures run from September 2013 (one month before health exchanges launched) to March 6, several weeks before the end of the first open-enrollment period. Sign-ups surged in those few weeks, and the White House recently announced 7.1 million people ended up selecting private insurance plans through the online marketplaces through March. That number slightly exceeded the original 7 million estimate from the Congressional Budget Office, which scaled down its projection to 6 million after serious technical problems marred the start of enrollment.

The Urban Institute found the rate of uninsured adults dropped 2.7 percent since September 2013, from 17.6 percent to 15.2 percent, which translates to about 5.4 million adults. States that expanded Medicaid are now at 12.4 percent uninsured, while 18.1 percent of the population in states that did not expand Medicaid remain uninsured.

The L.A. Times used more recent enrollment data from a variety of surveys and reports, including information from an as-yet-unpublished survey by the Rand Corporation, another think tank. Another key difference: Rand estimates 3 million young adults have opted to stay on their parents’ health plan until they turn 26.

The final tally after including people who were given a two-week grace period because of technical glitches will likely be different from the estimates from either report, both of which represent the best guesses of researchers at this point.

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