Surprising Statistics on the Uninsured

In late May, the National Center for Health Statistics (NCHS), a unit of the Centers for Disease Control and Prevention (CDC), released its estimates of the uninsured for 2017.1 Despite the unsuccessful efforts of congressional Republicans and the urgings of the president to pass legislation repealing the Affordable Care Act (ACA), as well as the instability that this uncertainty about the ACA’s future may have produced, the number of uninsured remained at 29 million Americans, or 9.1% of the population. This number is down from the 48 million Americans (or 16% of the population) who were uninsured in 2010, the year the ACA was enacted and during which time the country was still being impacted by the 2008 recession. The 2017 number of uninsured, however, does not reflect the effect of eliminating the financial penalty for not having any insurance—the so-called insurance coverage mandate. This change does not go into effect until 2019, although it is unclear how vigorously the Treasury Department will audit 2018 income tax forms for evidence of insurance coverage.Although some policy analysts may have been surprised by the report of stable coverage for 2017, these numbers are not surprising to me given that the majority of newly insured came from expansions in Medicaid coverage, which, to date, has not been negatively affected by the change in administrations. According to a February 2016 report from the Centers for Medicare & Medicaid Services (CMS), Medicaid and the Children’s Health Insurance Program (CHIP) had added 14.5 million people as of the end of 2015.2 Some of the individuals added were eligible under the pre-ACA rules but only joined after the ACA was implemented; others were made eligible as a result of the Medicaid expansion in the ACA.