As Obamacare goes forward, guess where more are covered?

More people have health coverage than before, as Obamacare is working.

The newly covered include people who signed up for private insurance or got coverage through Medicaid or via their parents’ plans.

The proof? Look to data on the percentage insured and uninsured.

These data are not fully up to date yet, but see this graph from Gallup that goes through the end of February 2014.

Gallup will be updating this but has already reported that the percentage of uninsured has continued to drop.

(Note that Gallup includes all adults over 18 and so their figures are affected by Medicare coverage, which is received by all citizens over 65.)

But where is the rate of uninsurance dropping the most? 

Here’s data from the Urban Institute’s Health Reform Monitoring Survey on coverage for adults 18-64.

Note that, like the Gallup data, the time covered does not include the big surge at the end. These data only goes through the early part of March.

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Fewer people lack insurance through the whole country, but the drop is larger and faster in states that expanded Medicaid.

From the very first point on the graph to the last:

  • The rate of uninsurance dropped from 15% to 12.4% in the states that expanded Medicaid. That’s a decline of 2.6 percentage points, a drop of 17.3%.
  • The rate of uninsurance dropped from 20.2% to 18.1% in the states that didn’t expand Medicaid. That’s a decline of 2.1 percentage points, a drop of 10.4%.

The states that expanded Medicaid had the biggest increases in coverage.

Given that they started with more covered to begin with, that’s rather remarkable. It should be easier to get a bigger increase in insurance coverage when a lower percentage are covered to begin with.

Now, it should be noted that the states that expanded Medicaid overlap quite a lot with the states that made strong commitments to sign up through the marketplaces. So these better improvements in coverage aren’t just from expanding Medicaid. Still, Medicaid expansion clearly put a dent in the percentage uninsured.

What will Obamacare foes say to this?

So far, many foes of the program claim that there’s been a very small net increase in the number insured.

Other Obamacare opponents even say that the number with coverage has gone down because some people had non-compliant plans canceled.

What both of these ACA foes ignore is that, per a study by RAND, the vast majority of those individuals bought insurance “off-exchange,” that is, without using the health care marketplace. Thus it makes no mathematical sense to subtract people whose plans were canceled from the total who obtained insurance through the marketplace.

While we can keep arguing about the precise numbers, what they shouldn’t be able to ignore is that the percentage of uninsured has gone down, which, by simple subtraction, means the percentage of insured has gone up.

And expanding Medicaid is part of getting more people covered, so they can get care.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.