Survey: Number of Uninsured U.S. Residents Dropped by 3.8M in Q1

The number of uninsured U.S. residents declined by about 3.8 million in the first quarter of 2014, according to a survey released Tuesday by CDC's National Center for Health Statistics, the Wall Street Journal reports (Radnofsky, Wall Street Journal, 9/16).

According to Politico, the results do not take into account individuals who signed up for plans near the end of the Affordable Care Act's initial open enrollment period, as their coverage would not have begun until April or later (Norman, Politico, 9/16).

Survey Details

For the survey, researchers interviewed 27,672 U.S. residents from January through March (Wall Street Journal, 9/16). According to the New York Times, the survey's results are considered particularly accurate by researchers because the interviews are conducted in residents' homes (Tavernise, New York Times, 9/16). In addition, the survey includes more questions and more follow-up by researchers than most private online or telephone surveys, according to the Times' "The Upshot" (Sanger-Katz, "The Upshot," New York Times, 9/16).

Survey Findings

The survey found that the uninsured rate declined from 14.4% in 2013 to 13.1% -- representing 41 million U.S. residents -- in the first quarter of 2014 (Wall Street Journal, 9/16).

Specifically, the percentage of U.S. residents with private coverage increased from 59.5% in 2013 to 60.5% during the first three months of 2014, and the percentage of U.S residents with public insurance increased from 33.8% in 2013 to 34.4% in the first quarter of 2014 (CDC survey, 9/14). The largest decline in the uninsured rate occurred among residents ages 19 to 25, with 27% reporting being uninsured in 2013, compared with about 21% in the first quarter of this year (New York Times, 9/16).

In addition, researchers estimated that during January through March:

• 17.8% of U.S. residents -- 55.5 million people -- had lacked insurance for at least part of the 12 months prior; and
• 9.6% of U.S. residents -- 29.9 million people -- had lacked insurance for more than a year (CDC survey, 9/14).

The percentage of individuals who had been uninsured for more than one year declined among all age groups except children from 2013 to the end of the first quarter. The largest such decrease -- from 19.8% in 2013 to 14.9% at the end of March -- occurred among adults ages 19 to 25.

Further, the survey found a larger drop in the uninsured rate in states that expanded Medicaid under the ACA than in non-expansion states. Specifically, the uninsured rate for U.S. adults declined from 18.4% in 2013 to 15.7% at the end of Q1, while "there was no corresponding significant decrease" in non-expansion states (Politico, 9/16).

Researchers also found that the percentage of U.S. residents with high-deductible health plans has increased (Wall Street Journal, 9/16). Specifically, about 36% of respondents were enrolled in such plans, compared with 33.9% in 2013 and 22.5% in 2009 (CDC survey, 9/14).

Reaction

Larry Levitt -- director of the Kaiser Family Foundation's Program for the Study of Health Reform -- said that the findings "dramatically understate the effect" of the ACA because of how many of the law's signups were not accounted for in the data. He added, "Regardless of what you think of the ACA, there should be no doubt at this point that the law is increasing the number of people insured."

Meanwhile, MIT economist Jonathan Gruber -- a former Obama administration health policy adviser who helped craft the ACA -- stressed that "[i]t is too early" to assess the law's effect and that there "is really a three-year process of implementation" (New York Times, 9/16).

Report co-author Robin Cohen said, "This is the beginning of our analysis," and noted that CDC would issue a new report that accounts for more 2014 insurance signups in December (Wall Street Journal, 9/16).