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Uninsured Rate Held Steady Through End of 2017

News  |  By Gregory A. Freeman  
   January 22, 2018

Shorter sign-up period and lack of advertising did not trim ACA exchange enrollment. But the uninsured rate may increase in 2018.

The percentage of American adults without healthcare insurance remained steady in the last quarter of 2017 after rising earlier in the year, according to a recent Gallup poll. The rate had risen 1.3% as insurance companies stopped selling plans in some regions, and some consumers responded to rising insurance premiums and deductibles by forgoing insurance altogether.

The uninsured rate held steady at 12.2% in the last quarter, up from 10.9% in the same quarter of 2016—the lowest rate of uninsured Americans since Gallup started measuring the rate in 2008.

Related: Uninsured Rate Falls To A Record Low

Gallup notes that the Trump administration practically eliminated the advertising for ACA exchange signups, reducing the budget by 90%, while also cutting the sign-up period by half. Those actions apparently had little or no effect on signups, Gallup says, because the number of people buying coverage on the ACA exchanges for 2018  was almost the same as for 2017.

The increase of 1.3% earlier in the year still means an additional 3.2 million people were uninsured in 2017 over 2016.

“Despite the uninsured rate rising in 2017, it remains well below its peak of 18.0% measured in the third quarter of 2013, prior to the implementation of the ACA's healthcare exchanges and the requirement that most adults have health insurance or be subject to a fine, commonly known as the individual mandate,” Gallup reports. “The uninsured rate rose for all demographic groups in 2017, with the exception of those aged 65 and older, all of whom qualify for Medicare coverage. It increased most among young adults, blacks, Hispanics and low-income Americans. Importantly, the uninsured rate among adults aged 18-25 rose by 2.0 points in 2017. Young adults serve a critical function in healthcare markets because their low usage of healthcare helps offset the higher costs of insuring older Americans.”

Gallup found that the uninsured rate rose more in 2017 for blacks and Hispanics than for the population overall, a 2.3% and 2.2% increase respectively.

“By far, the biggest change in 2017 was the decline in the percentage of Americans purchasing their own plans, likely through ACA healthcare exchanges. In the last quarter of 2017, 20.3% of Americans said they bought their plan themselves, down 1.0 point from 21.3% at the end of 2016,” Gallup reports. “This decline in the percentage of Americans who pay for their own coverage marks a reversal of the trend seen since the ACA's individual mandate took effect in the third quarter of 2013. Between then and 2016, the percentage of adults with coverage via self-paid plans had grown 3.7 points.”

The Gallup report predicts an increase in the uninsured rate in 2018, driven by the repeal of the individual mandate and continued increases in premiums and deductibles.

“Young adults will be most likely to go without coverage, meaning that they will no longer help offset the costs of older, less healthy adults—which will drive up premiums even more,” the report says. 

Gregory A. Freeman is a contributing writer for HealthLeaders.

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