The Affordable Care Act allowed the uninsured rate nationally to drop this year from 20 percent to 15 percent among adults 19 to 64 years old, a new report found. But in places such as Georgia, which did not expand Medicaid, the uninsured rate remains high, particularly for the poor.
The report today from The Commonwealth Fund follows research it reported last week in the New England Journal of Medicine that an estimated 20 million people gained coverage. In the new report, looking at those it considers “working age adults” or those 19-64, 9.5 million gained coverage through the marketplace, either in a private health insurance plan or through Medicaid. Of those, 59 percent who chose a private plan had previously been uninsured and 66 percent of those who chose Medicaid had lacked coverage, according to the new report.
The report broke out numbers for the six largest states, including Florida, but not for Georgia. A separate report from WalletHub, however, found Georgia’s uninsured rate is still above 18 percent, the 10th highest rate in the country, despite a 3.5 percent drop attributed to enrollment in the marketplace. That report said more than 316,000 in Georgia enrolled in private insurance through the marketplaces and more than 188,000 in Georgia got Medicaid.
Still, The Commonwealth Fund report shows there is “a substantial decline in the nation’s uninsured rate among working age adults,” President David Blumenthal said. “The greatest gains were among groups who have historically experienced high uninsured rates, including young adults ages 19-34, Latinos and people with low incomes.”
But there were substantial differences among states, particularly among those that expanded Medicaid and those that did not.
In the 25 states and District of Columbia that expanded, the rate among people below the federal poverty level dropped from 28 percent to 17 percent.
In the 25 states that did not expand, the rate went from 38 to 36 percent, which was not statistically significant, said Sara Collins, the vice president of health care coverage and access for the group.
In California, which expanded Medicaid, the uninsured rate was cut in half, from 22 to 11 percent, while in Florida, which did not expand, the rate dipped only slightly from 30 percent to 26 percent.
Those that gained coverage seemed to like it. Even among Republicans, 74 percent said they were somewhat or very optimistic about their coverage.
“Large majorities of adults with new coverage regardless of prior insurance status, age, political affiliation or new coverage source are optimistic that their new insurance will improve their ability to get the health care that they need,” Collins said.
About 60 percent of them said they already had used their coverage; among those, 62 percent said they would not have been able to access or afford it without the new plan, Collins said.
“Three-quarters of people who were uninsured when they enrolled and had used their new coverage said they would not have been able to get this care prior to getting their new health insurance,” Collins said. “But 44 percent of adults who had insurance when they enrolled also said they would not have been able to get this care before they enrolled in their new plan.”