Trends in Health Insurance Enrollment, 2013-15

Published in: Health Affairs, v. 34, no. 6, June 2015, p. 1044-1048

Posted on RAND.org on May 08, 2015

by Katherine Grace Carman, Christine Eibner, Susan M. Paddock

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Research Questions

  1. How did the number of people with health insurance change between October 2013 and April 2015?
  2. What were the sources of coverage for the newly insured?

This analysis examined insurance transitions between September 2013 and February 2015, before and after the Affordable Care Act's coverage-related provisions took effect in 2014. It found that 22.8 million people gained coverage and that 5.9 million people lost coverage, for a net increase of 16.9 million people with insurance.

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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