The Commonwealth Fund released findings last Tuesday, May 1 that the increased health insurance coverage under the ACA may be going in reverse. There new survey indicates that the uninsured rate is now 15.5 percent, up from 12.7 percent in 2016. That means about 4 million people have lost coverage in two years. They find the decreases are the result of two likely factors:

• lack of federal legislative actions to improve specific weaknesses in the ACA; and
• actions by the current Administration that have exacerbated those weaknesses.

They highlight the Administration actions such as deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period, and other actions that collectively may have left people with a general sense of confusion about the status of the law.

The analysis concludes that there will likely be further erosion of insurance coverage in 2019 with the repeal of the individual mandate penalty included in the 2017 tax law, actions by the Administration to increase the availability of insurance policies that don’t comply with ACA minimum benefit standards, and support for Medicaid work requirements.

Reduced insurance coverage was most notable among adults with family incomes of under $61,000 and among Republicans. The uninsured rate rose from 7.9 percent to 13.9 percent among Republicans and held steady at 9.1 percent among Democrats.

The rate also rose to 21 percent in the current 19 states that have not extended the expanded Medicaid coverage. A provision that allows the states to expand Medicaid with the Federal government picking up 90 percent of the cost. The increased uninsured rate was up by about 1 percent. By comparison the uninsured rate in the remaining 31 states was near 10 percent.

Currently the state of Maine is attempting to opt into Medicaid but the Governor is unwilling to obey the result of a ballot vote by the people of Maine who approved the expansion last November. In addition the state of Virginia with a vastly different state legislature after last year’s election also looks close to opting into the Medicaid expansion. There are also likely successful efforts in both Utah and Idaho to put the question on this year’s November ballot.

The uninsured rate is highest among 35 to 49 year olds at approximately 19 percent with rates for 19-34 year olds and 50 to 64 years old lower. This 35 to 49 year old population is also approximately the same part of the population in some parts of the country that are experiencing higher suicide, drug overdoses and other health-related problems resulting in increasing mortality rates.

For further information examine: First Look at Health Insurance Coverage in 2018.

About the Author:

John Sciamanna is CWLA's Vice President of Public Policy.

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