National uninsured rate climbed in 2017

About 700,000 fewer people were enrolled in health insurance coverage in 2017 compared with the year before, marking the first year that the uninsured rate has increased since the Affordable Care Act’s major reforms took effect, according to a study published last week.

The Urban Institute study, funded by the Robert Wood Johnson Foundation, found the uninsured rate rose 0.2 percentage points from 2016 to 2017 to 10.2% of people under age 65, despite a strong economy and enrollment gains in the employer-sponsored insurance market. In all, 27.3 million people were uninsured in 2017.

The drop was driven by lower enrollment in the individual insurance market, which includes the ACA exchanges, as well as Medicaid and the Children’s Health Insurance Program, per the report. Coverage losses were concentrated in the 19 states that did not expand Medicaid under the ACA by July 1, 2017. In those states, the uninsured rate rose to 14.3% in 2017 from 13.7% the year before. The uninsured rate held steady at 7.6% in states that did expand Medicaid.

Losses in coverage spanned age groups and income levels, but were mostly concentrated among non-Hispanic white and non-elderly black people and those with at least some college education, the report stated.

Other studies have also found the uninsured rate is rising. In January, Gallup said that 13.7% of adults were uninsured during the fourth quarter of 2018, compared with 13.4% in the first quarter of 2014. But while the uninsured rate is increasing, it’s still far lower than when it hit its peak of 18% in 2013, before the ACA was implemented.