Drumroll, Please

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The March 31 deadline for open enrollment in plans offered on the healthcare exchanges has now passed.  The original goal was 7 million enrollees.  And the actual number was … 7.1 million.  Whew!

Some of these are folks that had previously had insurance, and were simply exchanging one plan for another.  But a recent study from the Urban Institute Health Policy Center shows that the number of uninsured adults in the US decreased by at least 5.4 million since enrollment began in October 2013.  This represents a drop of 2.7 percentage points, or a relative decrease of 15%.

I say at least because the data come with 2 caveats.  First, it does not reflect enrollments in the last couple of weeks of March, when activity surged.  Second, it does not show the effect of other provisions that have been shown to increase coverage, especially the provision allowing young adults to remain on their parents’ insurance until age 26 (that number is estimated to be about 3.1 million).

This is a huge improvement in America’s shameful status among developed countries in providing healthcare coverage for its citizens.  The impact could have been even greater.  The drop in uninsured was less than half as big in the 24 states that opted not to expand Medicaid compared with those that did, leaving millions more uninsured.

BUT – I’m not giving 3 cheers yet.  The stated goals of the Affordable Care Act were to expand coverage (good start but more work to do), and to decrease costs (still more work to do).  In a previous blog I talked about how the ACA has likely already had a positive impact on healthcare spending.  However, now that there are millions more Americans with coverage, demand may start to increase, potentially reversing some of those gains.

Nevertheless, while the jury is still out, I think 8.5 million Americans with insurance coverage they didn’t used to have is something to celebrate.  I’m sure those people are celebrating.

4 Responses to Drumroll, Please

  1. Steines, Sara says:

    Well said.

    Sent from my iPhone

    • Clearly some numbers are subject to interpretation, as they are based on estimates and self-reports. But that cuts both ways. For example, increases in Medicaid are attributed to “natural growth.” But if that is true, why is the increase so much larger in states that opted in to the Medicaid expansion? I don’t have the data, but it strains credulity that the 26 states with ACA-associated Medicaid expansion had 2.5 times the “regular Medicaid growth” as the other 24. Similarly, the Reason article cites the many people who have lost employer coverage as an offset. But the trend toward less employer-provided insurance predates the ACA and has been going on for years.

  2. […] millions of people newly insured thanks to the Affordable Care Act, a lot of people will be seeking medical care for the first time […]

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