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Analysis: Net Increase of About 9.3M Newly Insured Under ACA

Analysis: Net Increase of About 9.3M Newly Insured Under ACA

April 10, 2014 — Between September 2013 and mid-March 2014, an estimated 9.3 million U.S. residents gained health coverage under the Affordable Care Act (PL 111-148), according to a new analysis by RAND, Modern Healthcare's "Vital Signs" reports (Dickson, "Vital Signs," Modern Healthcare, 4/8).

The data were gleaned from monthly surveys that RAND has conducted since November 2013 about insurance choices and public opinion, and a separate September 2013 survey about insurance choices. The new analysis includes responses from 2,425 adults ages 18 to 64 who participated in the two surveys (Carman/Eibner, "The RAND Blog," RAND, 4/8).

Researchers noted that their analysis was based on a small sample of the entire population, which means that the margin of error is "relatively large." They also noted that the final survey used for the analysis was conducted before the enrollment surge in the ACA's insurance marketplaces in the final half of March, suggesting that the number of insured individuals has potentially increased since then (Easley, "Healthwatch," The Hill, 4/8).

Analysis Details

For their analysis, researchers took into account individuals who signed up for coverage through the marketplaces beginning in October 2013, purchased plans directly from insurers, became eligible for Medicaid under the ACA or lost coverage in 2013.

According to the Los Angeles Times' "Politics Now," researchers deduced that at least 14.5 million previously uninsured adults gained coverage from 2013 through mid-March 2014, while about 5.2 million people lost or gave up coverage. Most of those who gave up or lost coverage had health plans through an employer; fewer than one million had purchased their insurance on the individual market.

The net coverage gain was about 9.3 million, according to the RAND report (Lauter, "Politics Now," Los Angeles Times, 4/8). Meanwhile, the national uninsured rate declined from 20.5% to 15.8% between September and mid-March, researchers said.

The analysis also found that about 1.4 million of the 3.9 million who enrolled in a marketplace plan by mid-March were previously uninsured ("Vital Signs," Modern Healthcare, 4/8).


The analysis counters predictions by both supporters and opponents of the ACA who suggested that employer-sponsored coverage rates would decline under the law, according to "Politics Now" ("Politics Now," Los Angeles Times, 4/8). The analysis found that the bulk of newly insured individuals -- about 8.2 million -- had employer-sponsored insurance ("Healthwatch," The Hill, 4/8).

Overall, RAND found that the ACA did not affect coverage choices for the majority of insured U.S. residents, as 80% of study and survey participants reported having the same type of coverage in March 2014 and in September 2013 ("Vital Signs," Modern Healthcare, 4/8).