WASHINGTON - In addition to gains in insurance coverage as a direct result of the Affordable Care Act, the number of Americans covered by employer-provided insurance also has increased in the last year, according to newly released data from the Rand Corp.
As previously reported by my colleague Noam N. Levey, Rand estimated that the number of Americans with health insurance rose by about 9.3 million as of mid-March. The group's researchers note that the number probably has increased as their survey missed much of the final surge of enrollments in the online marketplaces created by the healthcare law, also known as Obamacare.
The share of Americans aged 18 to 64 who lack coverage dropped from 20.5% to 15.8% by Rand's calculations.
The 9.3-million increase in coverage, which takes into account people who lost coverage, includes people who enrolled in plans on the marketplaces, those who bought a plan directly from an insurer and those who became eligible for Medicaid. About half the states have expanded Medicaid under the law's provisions.
But the full Rand report, released Tuesday, notes that the figure also includes a significant increase in employer coverage. That increase contradicts predictions made by both opponents of the law and some of its supporters who had expected employer coverage to drop when the 2010 healthcare law took effect.
Rand researchers attribute some of the gains to the decline in unemployment over the last several months, noting that some previously uninsured people may simply have found jobs that provide insurance. In other cases, companies may have added insurance coverage in anticipation of the law's health insurance provisions taking effect.
The insurance market always features considerable churn as people gain or lose jobs, switch insurance plans or move in and out of eligibility for Medicaid. Between 2013 and mid-March of 2014, Rand estimates that 14.5 million people aged 18 to 64 who had previously been uninsured gained coverage while 5.2 million who previously had insurance either lost it or gave it up. The difference provides the net increase in coverage of 9.3 million people.
Most of those who lost or gave up insurance previously had employer-provided coverage. Fewer than 1 million of them had coverage bought on the individual market. That would include those who had plans that were canceled because they did not comply with the law's new standards.
Final, definitive, numbers on coverage, which will come from the Census Bureau, won't be available for many months. So for now, the surveys provide the best look at how the law has changed insurance markets.
While the exact numbers remain uncertain, the direction of the change is not. "Early evidence from our nationally representative survey indicates that the ACA has already led to a substantial increase in insurance coverage," Rand concluded.