END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

MAJOR UPDATE x2: GALLUP: Uninsured rate drops to 11.4% as of end of June 2015

Some Guy, 3/04/15:

Furthermore, anyone who enrolled/enrolls between around February 23rd and March 15th (varies by state) will start coverage on April 1st...and then, on May 1st, the bulk of the #ACATaxTime Special Enrollment Period enrollees will be kicking into gear. Don't forget off-exchange enrollees, ongoing Medicaid expansion, etc...I wouldn't be at all surprised to see the national uninsured rate drop to below 12% by April.

Gallup, 4/13/15:

The uninsured rate among U.S. adults declined to 11.9% for the first quarter of 2015 -- down one percentage point from the previous quarter and 5.2 points since the end of 2013, just before the Affordable Care Act went into effect. The uninsured rate is the lowest since Gallup and Healthways began tracking it in 2008.

Some Guy, 4/13/15:

In addition...the Gallup survey still doesn't take into account a few other factors:

  • Anyone who enrolled (either on or off the exchanges) between 2/23 - 3/15 didn't have their policy coverage kick in until April 1st, which isn't included in the survey...
  • The Gallup surveys don't account for children under 18 whatsoever, who make up about 23% of the total population, or around 74 million...

In other words, it's conceivable that the actual uninsured rate as of today (mid-April) may be as low as 11.6% or even lower.

Gallup, Today:

WASHINGTON, D.C. -- The uninsured rate among U.S. adults aged 18 and older was 11.4% in the second quarter of 2015, down from 11.9% in the first quarter. The uninsured rate has dropped nearly six percentage points since the fourth quarter of 2013, just before the requirement for Americans to carry health insurance took effect. The latest quarterly uninsured rate is the lowest Gallup and Healthways have recorded since daily tracking of this metric began in 2008.

That's a 30% drop since March 2010, or a 36.7% drop since October 2013 for all adults.

There's about 320 million people in the U.S., of which around 245.4 million are adults. 11.4% of that is roughly 28 million people.

As I've noted before, the official Gallup graph is a bit misleading, as it cuts off the first 10%. The higher-resolution version above is a far more accurate representation, while still being extremely impressive (and which has the 2 key dates marked for reference: the ACA being signed into law in March 2010, and the ACA exchanges being launched in October 2013).

As I've also noted repeatedly, the Gallup surveys (along with most other phone surveys) don't include children under 18, presumably for legal reasons. The uninsured rate for kids under 18 was about 8% in 2013. There were roughly 74 million kids under 18 in the U.S. in 2013, so that's around 5.9 million uninsured at the time.

Again, it's safe to assume that this has gone down as well, although probably not as dramatically as for adults. A similar 36.7% drop would be around 2.2 million children (taking population increase into effect), but even half of that would still lop a good million children off the uninsured tally...or an additional 0.3% of the total population.

In other words, it's likely that the actual uninsured rate for the entire U.S. population (all 320 million of us) is down to around 28 million adults + 4.9 million children, around 33 million total...or 10.3% of the entire population.

Going forward, I'm actually not expecting the Q3 2015 Gallup survey to show much of a change; we're in the heart of the off-season, the #ACATaxTime additions have already been accounted for, and Montana is the only state which is expected to expand Medicaid anytime soon, so Q3 will probably hold steady at 11.4%, give or take; the rate might even inch up a few tenths of a percent due to attrition. Still, the overall picture is pretty dramatic: Whatever else you can say about the ACA in terms of cost, it's definitely accomplishing the other half of its goal: The total number of uninsured Americans has been cut by about 16 million people since October 2013.

UPDATE: As someone noted a few minutes ago, it's important to remember that of the 33 million or so who are still uninsured nationally, about 3.7 million of them fall into the "Medicaid Gap" due to GOP obstruction of ACA Medicaid expansion, while an additional 6 million or so are undocumented immigrants who are ineligible for either Medicaid or federal tax credits to enroll in private plans. That leaves just 23.3 million or so remaining who are "realistically insurable" under the current legal situation. See the revised graph below which gives a rough representation of each (the Medicaid Gap has actually dropped from over 4 million to 3.7 million since 2013 as states like Pennsylvania and Indiana have added themselves to the expansion list).

Of those 23 million or so, around 17.7 million are eligible for coverage via the ACA exchanges, while the remaining 5.6 million are a combination of those still eligible for Medicaid expansion, those eligible for "traditional" Medicaid and a mish-mash of "other" (including rounding errors and/or overlaps in some of the other categories).

UPDATE x2: I just realized something else.

  • Adults over 18 make up appx. 76.7% of the total U.S. population.
  • The current U.S. population (2015) is roughly 320 million people.
  • That means there's appx. 245.4 million adults in the U.S.
  • The Gallup survey from the end of March had the adult uninsured rate at 11.9%.
  • The Gallup survey from the end of June has the adult uninsured rate at 11.4%.
  • That means 0.5% of all U.S. adults gained insurance coverage in the past 3 months...after the official Open Enrollment Period enrollees had already started their coverage.
  • 0.5% of 245.4 million = 1.22 million people.

That's right: The uninsured rate dropped by another 1.2 million people in the second quarter of 2015...not including the 2nd Open Enrollment Period enrollees.

Who are these extra folks? Well, about 185,000 or so of them are likely those of the 214,000 #ACATaxTime enrollees who signed up between 3/15 - 4/30 to avoid the tax penalty for non-coverage. However, that still leaves over 1 million others. Of those 1 million others, I'm estimating that roughly 700,000 of them have been added to Medicaid (either via expansion, as woodworkers or simple "traditional Medicaid" additions). The other 300K or so are presumably receiving employer-sponsored insurance or have aged into Medicare eligibility.

In any event, that's a pretty impressive drop by any standard.