CDC Data Show U.S. Uninsured Rate Fell to 11.9% in Q3 2014

The uninsured rate among all U.S. residents declined to 11.9% in the first nine months of 2014, which is down sharply over recent years, according to preliminary data from CDC's National Health Institute Survey, Modern Healthcare reports (Kutscher, Modern Healthcare, 5/28).

For the survey, researchers interviewed 85,224 U.S. residents between January 2014 and September 2014 (CDC survey, May 2015).

Background

The data come as the Affordable Care Act's subsidies to help U.S. residents purchase coverage through the federal exchange are being challenged in King v. Burwell. The Supreme Court heard oral arguments in the case in March and will release a decision by the end of June. If the court strikes down the federal exchange subsidies, the ruling would eliminate about $28.8 billion in subsidies to 9.3 million individuals in 34 states in 2016, according to an Urban Institute analysis (California Healthline, 5/19).

As a result, the analysis found that the number of uninsured U.S. residents could increase by more than eight million by 2016 because fewer individuals would be able to afford coverage and many healthier individuals could drop their coverage (California Healthline, 1/23).

Survey Findings: Uninsured

The survey found that the uninsured rate declined among all income groups between 2013 and the first nine months of last year, with the greatest decline coming among individuals with incomes below 200% of federal poverty level (Modern Healthcare, 5/28).

Meanwhile, the survey found that the uninsured rate among adults ages 18 to 64 declined to 16.7% during the survey period, compared with 20.4% in 2013 (CDC survey, May 2015).

In addition, the survey found a larger drop in the uninsured rate in states that expanded Medicaid under the ACA than in non-expansion states. The uninsured rate for U.S. adults under age 65 in expansion states during the study period was 11.5%, a 3.4 percentage-point drop from 2013. By contrast, the uninsured rate for U.S. adults under age 65 in non-expansion states was 16.3% during the first nine months of last year, a 2.1 percentage-point decrease.

Survey Findings: Coverage Type

The survey also found that the percentage of U.S. adults under age 65 with incomes between 100%  and 200% of poverty level with private coverage increased from 33.4% in 2013 to 37.9% during the first nine months of 2014.

Researchers also found that the percentage of U.S. residents who purchased exchange coverage increased from 1.4% in the first quarter of last year to 2.5% in the third quarter of 2014.

Further, researchers found that a higher percentage of individuals had high-deductible plans compared with the previous year. Specifically, during the first nine months of last year:

• 23.6% of adults under age 65 had a high-deductible plan but did not have a health savings account, compared with 22.2% in 2013; and
• 13.1% of adults under age 65 had a high-deductible plan with a health savings account, compared with 11.7% in 2013 (Kutscher, Modern Healthcare, 5/28).

Largest U.S. Insurer Would Expect King Fix if Subsidies Struck Down

In related news, UnitedHealth Group President and CFO David Wichmann said his company expects that lawmakers will pursue remedial action in the event that the Supreme Court strikes down subsidies to help U.S. residents purchase coverage through the federal exchange in King.

He said, "There will be a response, and we'll be positioned to aid in that response" so that individuals can keep their coverage. UnitedHealth Group is the largest health insurer in the U.S.

Wichmann declined to predict how the high court will rule in the case (Herman, Modern Healthcare, 5/28).