The sharp plunge in the number of Americans lacking health coverage has continued in the second quarter of 2015, pushing the uninsured rate down to a record low, a new Gallup survey shows. The decline is evidence of lasting improvement following a sharp first-quarter drop, thanks to the Affordable Care Act.
In the second quarter of this year, the uninsured rate fell to 11.4 percent, down from 11.9 percent in the first quarter and the lowest rate recorded since Gallup began daily tracking of the figure in 2008, according to the results of the latest Gallup-Healthways Well-Being Index poll.
Gallup pointed to a notably sharp drop in the uninsured rate in February of 2015 — during the year’s first quarter — coinciding with the Feb. 15 open enrollment deadline. Overall, the national uninsured rate has plummeted by nearly 6 percentage points since the fourth quarter of 2013, when the main provisions of the Affordable Care Act were implemented.
All age groups, except those over 65, saw a drop of at least 5.7 percentage points from the fourth quarter of 2013 to the most recent quarter. The rate of uninsured people over 65 years old remained stagnant during that period (due to Medicare coverage, which was unchanged by the Affordable Care Act). The decrease in uninsured rates was particularly notable among young adults, with an average drop of nearly 8 percentage points among 18- to 25-year-olds and 26- to 34-year-olds.
The uninsured rate dropped across all racial subgroups, but Hispanics and African-Americans — who have historically had the lowest rates of coverage — saw the greatest gains, with the percentage of uninsured dropping by 9.6 and 8.9 points, respectively. And all income brackets saw higher rates of coverage. Americans in the lowest income bracket — those with an annual household income of less than $36,000 — saw a 9.9 percentage point drop in the rate of uninsured since the fourth quarter of 2013, the sharpest drop among the three income brackets surveyed.
The results come only a few weeks after the Affordable Care Act survived its second major Supreme Court challenge. The court’s ruling preserved health care coverage for millions; if the high court had ruled the other way, people in 34 states would have lost eligibility for subsidies, and the uninsured rate would have increased.
Gallup’s findings are consistent with numerous other surveys taken since last year, including a recent report from the Centers for Disease Control and Prevention’s National Health Interview Survey, one of the most comprehensive analyses of health coverage in the United States. The CDC’s estimate of the national uninsured rate — 11.5 percent — is nearly identical to Gallup’s estimate of 11.4 percent. Also in line with Gallup’s findings, the CDC report documented coverage gains across the entire population, with the most pronounced gains among minorities and low-income Americans.
These figures confirm that the Affordable Care Act is achieving it’s primary goal of reducing the number of uninsured Americans. However, Republican opposition to the health care law has created problematic gaps in coverage across many red states. According to the CDC, the ten states with the highest rates of uninsured residents are all governed by Republicans who rejected the Affordable Care Act’s Medicaid expansion. The graph below, from the Urban Institute’s Health Reform Monitoring Survey, sh0ws the disparity in coverage between expansion states and non-expansion states:
Overall, the average uninsured rate in states where GOP legislatures and governors have refused to allow the Medicaid expansion stands at 14.4 percent — nearly double the rate (7.5 percent) found in states that have accepted federal funds to expand Medicaid to include more low-income residents. In the three worst states — Alaska, Texas and Oklahoma, which are all run by Republicans — an average of 1 in 5 residents (20 percent) is uninsured.
The next enrollment period begins on Nov. 1, 2015. However, Gallup predicts that the drop in the uninsured rate won’t be as substantial because “those who remain uninsured are likely the hardest to engage.”