Number of Americans without health insurance reaches new low

In Commerce on March 31, people wait to complete paperwork to beat the deadline to acquire healthcare coverage through the Affordable Care Act.
(Al Seib / Los Angeles Times)

WASHINGTON — The share of Americans without health insurance has dropped to the lowest level since before President Obama took office, according to a new national survey that provides more evidence the healthcare law is extending coverage to millions of the previously uninsured.

Just 14.7% of adults lacked coverage in the second half of March, down from 18% in the last quarter of 2013, the survey from Gallup found.

The survey results, which track with other recent polling data and enrollment reports, indicate that about 8 million people have gained health insurance since September. That figure takes into account any losses in coverage the law may have brought about by the cancellation of health plans that did not meet the new standards.

Gallup’s survey highlights a historic expansion in coverage unparalleled since the creation of Medicare and Medicaid half a century ago.


It also undermines critics’ persistent claims that the law has done little to expand health insurance.

“The uninsured rate has been falling since the fourth quarter of 2013 … a sign that the Affordable Care Act, commonly referred to as Obamacare, appears to be accomplishing its goal of increasing the percentage of Americans with health insurance coverage,” Gallup’s Jenna Levy wrote in an article describing the new poll results.

The gains found by the survey would include several new sources of coverage.

Under the law, Americans could begin shopping Oct. 1 for health coverage on new marketplaces in which insurers could no longer turn away sick customers. As of the end of March, about 7.1 million people had signed up that way, the administration said. Some of them previously had no insurance.

In addition, in about half the states, low-income Americans could sign up for government Medicaid coverage for the first time, an option the law provides to states.

Even more Americans probably gained coverage under provisions of the healthcare law that took effect earlier. Those gains would not be reflected in the survey if people got covered before September.

For example, as many as 3 million young people gained coverage by staying on their parents’ health plans until they turn 26.

And more low-income Americans got coverage in states such as California that expanded their safety net programs ahead of 2014.


Without those earlier expansions, the nation’s uninsured rate would have been even higher before the marketplaces opened last fall. The percentage of Americans without insurance began climbing in the last year of the George W. Bush administration as the economy slid into recession, and it continued to rise over the following years.

The exact effect of the health law on insurance coverage remains difficult to pinpoint. The insurance market normally experiences substantial churn as Americans switch among different types of health coverage.

Gallup acknowledged the likelihood that not all of the new enrollees would pay their premiums and remain covered, a point that critics of the law emphasize. Failure to pay would return people to the ranks of the uninsured.

Others probably will gain coverage as the year goes on since some states, including Michigan and New Hampshire, are just starting to expand their Medicaid programs.


In addition, people who began applying for coverage by March 31 have until April 15 to complete their applications, which probably will add to the enrollment figures.

That “could further drive down the uninsured rate in the second quarter of 2014,” Gallup noted.

The Gallup survey provides strong evidence of a major national shift in coverage linked to the law.

The drop in uninsured rates was most pronounced among African Americans, Latinos and households earning less than $36,000 a year, three demographic groups targeted by the Obama administration and others working to enroll people under the healthcare law.


Gallup’s results closely parallel other surveys, including one from the Rand Corp. scheduled to be released this week, which was previously shared with The Times.

As part of its Gallup-Healthway Well-Being Index, Gallup surveys Americans throughout the year to produce quarterly estimates of the share of Americans without coverage as well as other data on the healthcare system.

The estimate for the whole first quarter of 2014, an average of 15.6%, is higher than the 14.7% estimated for late March because millions of Americans have been gaining coverage throughout the last three months during the law’s open enrollment period.