May 6, 2015 -- The number of people with health coverage grew by almost 17 million since the major provisions of the health care overhaul took effect, according to a study by the RAND Corporation published in Health Affairs.
While 42.7 million people lacked health insurance in September 2013—right before the start of the first open enrollment period—the study found that the figure dropped to 25.8 million in February 2015, which marked the end of the second open enrollment window. Almost 23 million people gained coverage, with most picking it up between September 2013 and May 2014, while nearly 6 million lost it.
The net increase of 16.9 million with health insurance is slightly above a federal government estimate in March that found that 14.1 million adults gained coverage since the start of open enrollment in 2013, though the study notes large confidence gaps mean it's possible the estimates are equivalent.
A recent Gallup survey found that the uninsured rate for U.S. adults for the first quarter of 2015 dropped to 11.9 percent, which was the lowest on record since tracking started in 2008.
"The ACA has greatly expanded health insurance coverage in the United States with little change in the source of coverage for those who were insured before the major provisions of the law took effect," the RAND study states.
During the study window, the authors projected that net enrollment rose by 9.6 million for Medicaid, 11.2 million for plans on the new health insurance exchanges and 8 million for employer-sponsored policies. Of the 11.2 million with coverage through the exchanges set up under the health overhaul, 4.1 million or 37 percent lacked insurance in September 2013.
At the same time, coverage through non-group plans decreased by 1.9 million and coverage through Medicare, military insurance, and other sources dropped by 10 million.
In addition, the study found that 80 percent of the 155.8 million with coverage in September 2013 did not change coverage sources during the research period while 47 percent of those who were uninsured at the start stayed that way. Citing concerns about cancellations, it also noted that only 600,000 people who initially had non-group coverage became uninsured.
"We found that the vast majority of those with individual market insurance in 2013 remained insured in 2015, which suggests that even among those who had their individual market policies canceled, most found coverage through an alternative source," the authors wrote.
Although many of the estimates were close to others already reported, the authors said a low cumulative response rate for their survey may have created bias.
