Dive Brief:
- The percentage of Americans without health insurance dropped to a historic low of 8% in the first quarter, a data point that President Joe Biden on Tuesday credited to the Affordable Care Act and improvements made to it through the American Rescue Plan.
- The uninsured rate for adults ages 18 to 64 declined to 11.8% in early 2022 from 14.5% in late 2020. For children through the age of 17, the percentage without insurance fell to 3.7% from 6.4%, the HHS said in a report from the Office of the Assistant Secretary for Planning and Evaluation. The findings are based on data from the National Health Interview Survey.
- The coverage gains come amid concerns that progress on reducing the uninsured rate could reverse if states resume Medicaid eligibility determinations when the COVID-19 public health emergency eventually lifts.
Dive Insight:
The uninsured rate began to decline after the Affordable Care Act was enacted in 2010 and dropped significantly when more ACA provisions went into effect in 2014. From 17.4% of the non-elderly population in 2010, the rate reached a low of 10% in 2016, but then began to creep upward.
Since the end of 2020, about 5.2 million previously uninsured people have gained health coverage, the ASPE report said. The total includes 4.1 million adults ages 18 to 64 and about 1 million children.
The coverage expansion coincides with implementation of the American Rescue Plan’s enhanced marketplace subsidies, the Medicaid continuous enrollment provision, several recent state Medicaid expansions and stepped-up outreach efforts, ASPE said.
About 5.4% of adults aged 18 to 64 reported having marketplace coverage in early 2022, compared to 4.4% in 2020, reflecting about 2 million new marketplace enrollees, or about half of the 4 million adults who got health insurance during the timeframe.
A record 35 million people are enrolled in ACA-related coverage, including 21 million who gained insurance due to the expansion of Medicaid, according to the White House. Marketplace sign ups reached an all-time high of 14.5 million during the 2022 open enrollment period.
Legislation that would extend the enhanced premium subsidies until 2025 provided by the American Rescue Plan is gaining momentum in Congress. Biden has urged Congress to pass the Inflation Reduction Act, saying it will lock in an average $800 a year in savings on health insurance premiums for 13 million Americans and prevent 3 million people from becoming uninsured.
The COVID-19 public health emergency declaration, which has been extended repeatedly during the pandemic, was renewed again on July 15. Policy experts have warned that once it expires, states will restart the process of checking the eligibility of Medicaid enrollees, potentially pushing millions of adults and children out of the program. The suspension of terminations during the pandemic has been a primary driver of Medicaid enrollment growth.