A 2015 RAND corporation study shows us the most recent report of gross enrollment numbers under the ACA at 22.8 million, while Medicaid sees 12 million.

According to the “Trends in Health Insurance Enrollment, 2013-15” RAND corporation study:

“22.8 million got coverage and 5.9 million lost plans for a net total of 16.9 million newly insured. 9.6 million people enrolled in employer-sponsored health plans, followed by Medicaid (6.5 million), the individual marketplaces (4.1 million), nonmarketplace individual plans (1.2 million) and other insurance sources (1.5 million). To clarify that is 4.1 million newly enrolled in the Marketplace and 7.1 who transitioned to Marketplace coverage for a total of 11.2 million. Likewise about 12 million enrolled under Medicaid according to a recent CMS report, while the RAND study concludes that only 6.5 million are newly enrolled due to the ACA.”

Remember ACA expanded coverage by: requiring large employers to cover people, offering small employers tax credits for providing coverage, expanding Medicaid and CHIP, creating Marketplaces with cost assistance, and letting young people stay on their parents plan. The ACA also improved Medicare, although we are only looking at non-elderly uninsured here.
  • The 16.9 million number mirrors a March 2015 HHS report that showed 16.4 million enrolled. However the HHS report focuses on young adults, Medicaid, and the Marketplace while the RAND study includes all insurance types, but then accounts for those who dropped their plans. Both reports rely on survey data and should be compared and contrasted.
  • Note that while the RAND study shows 4.1 million Marketplace enrollments, this number subtracts 7.1 million who they estimated transitioned to Marketplace plans for a total of 11.2 million. HHS by comparison estimated a total of 11.7 million enrolled in the Marketplace.
  • This study is notable as it is one of the first reports to give an estimate of employer and non-marketplace plans and take into account plan drops.
  • According to the study the largest source of coverage was employer coverage under the employer mandate. Considering about 50% of Americans get their coverage though work, as opposed to only about 15% on individual plans these are interesting findings.
  • The report concludes the number of uninsured Americans fell from 42.7 million to 25.8 million since October 2013.
  • According to the US Census Bureau, before the ACA in 2009 about 48.6 million or 15.7% of the population was uninsured.
  • The current US population is about 320 million. So 1% is 3.2 million. 3.2 divided by 25.8 = about 8% uninsured rate. To contrast a first quarter Gallup-Healthways poll on the other hand puts the rate at about 12%.

The information below are highlights from the 2015 RAND corporation study. See link below to read the full study.

Key Findings

Since the Affordable Care Act’s major provisions took effect, there has been an estimated net increase of 16.9 million people with health insurance.

  • 22.8 million people became newly insured.
  • 5.9 million people lost coverage.
  • The number of uninsured Americans fell from 42.7 million to 25.8 million.

Among those gaining coverage, the largest share (9.6 million) enrolled in employer plans.

  • 6.5 million enrolled in Medicaid.
  • 4.1 million enrolled through the Marketplaces.
  • 1.2 million enrolled in other non-marketplace individual plans.
  • 1.5 million used other sources (Medicare, military insurance, state plans).

An estimated 24.6 million Americans who were already insured moved from one source of insurance to another during the study period.

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