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‘Historic’ Gains: Obamacare Slashes Uninsured Rate By More Than A Third

affordable care act

More than 16 million previously uninsured Americans have gained health insurance coverage under the Affordable Care Act, according to an analysis published Monday by the Department of Health and Human Services.

The rapid expansion in access to insurance under the Affordable Care Act has pushed the nation’s uninsured rate from 20.3 percent in 2012 to 13.2 percent in the first quarter of 2015, the report shows. That represents a 35 percent drop in the number of Americans who lack insurance coverage.

Health and Human Services Secretary Sylvia Burwell said Monday that the latest figures show the “largest reduction in the uninsured in four decades.” Before the major coverage provisions of the Affordable Care Act were implemented, an estimated 47 million Americans did not have health insurance coverage.

Those gaining insurance since the law was passed in 2010 include 2.3 million young adults aged 18 to 26 who were able to remain on their parents’ health insurance plus another 14.1 million adults who obtained coverage through expansions of the Medicaid program, new marketplace coverage and other sources, the report shows.

Latinos, who traditionally have been least likely to have health coverage, have seen the largest drop in their uninsured rate, according to the report. The Latino uninsured rate fell 12.3 percentage points, from 41.8 percent to 29.5 percent. The uninsured rate for African Americans fell by nearly half, from 22.4 percent to 13.2 percent. The rate for non-Latino whites fell by just over 5 percentage points.

“Nothing since the implementation of Medicare and Medicaid has seen this kind of change,” said Richard Frank, assistant secretary for evaluation and planning at Health and Human Services.

States that expanded the Medicaid program to 138 percent of the poverty line saw significantly greater  reductions in their low-income uninsured populations – an average drop of 13 percent among people with incomes under the new Medicaid threshold, compared with a 7 percent drop in Republican-led states that have refused the expansion.

Evidence of Success

The new figures are consistent with numerous other data sources from the past few years, providing even more evidence that Obamacare is achieving one of its core goals of reducing the number of uninsured Americans, even as the Affordable Care Act remains embattled in Congress and faces an uncertain future at the Supreme Court.

Of course, the uninsured rate is only one measure of the law’s success. Other notable achievements of the law include impressive results on premiums and customer satisfaction rates; the lowest increase in health care spending in 50 years; the growing number of insurers who want to participate in exchange marketplaces; the reduced financial stress on families; the efficacy of Medicaid expansion; the efficacy of the medical-loss ratio; and the reduced medical errors system-wide.

And that’s not all: the Affordable Care Act is also helping struggling hospitals stay open, and allowing others to avoid cutting back on essential services like neonatal intensive care, trauma care, and organ transplant services. Hospitals in states that expanded Medicaid are reporting substantial reductions in the number of uninsured patient admissions, which is saving them millions in uncompensated care. Meanwhile, in non-expansion states, hospitals reported an increase in spending on uncompensated care. The Affordable Care Act is also saving the nation’s safety-net hospitals, which treat a disproportionate share of poor and uninsured people and therefore face billions of dollars in unpaid bills. Such facilities had expected to see a drop in uninsured patients seeking treatment, but the change has been faster and deeper than most anticipated— at least in the states that expanded Medicaid.

What’s more, the Affordable Care Act is actually going to cost less than it was expected to, according to new projections from the Congressional Budget Office projected. In new figures released this month, the CBO estimated that the federal government will spend $1.2 trillion over the coming decade expanding health coverage. That’s down 11 percent from a budget estimate issued in January, and even lower than earlier CBO predictions.

Unfortunately, though, many of the historic gains achieved under the health law could be reversed in the near future. The Supreme Court heard oral arguments this month in a lawsuit, King v. Burwell, that alleges the Affordable Care Act’s tax credit subsidies are only available in 13 states and the District of Columbia, which operate their own health insurance exchange marketplaces. The case is seen by most as a hyper-partisan attempt to gut the healthcare law, and the implications could be disastrous. The federal government set up the exchanges in 34 states, so millions of residents would lose their subsidies if the high court rules for the plaintiffs. The Rand Corp. estimates this would result in 9.6 million people becoming uninsured as their health insurance becomes too expensive and the markets in those states destabilize.



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