Gaining Ground: Americans’ Health Insurance Coverage and Access to Care After the Affordable Care Act’s First Open Enrollment Period
A new Commonwealth Fund survey finds that in the wake of the Affordable Care Act’s first open enrollment period, significantly fewer working-age adults are uninsured than just before the sign-up period began, and many have used their new coverage to obtain needed care.
The uninsured rate for people ages 19 to 64 declined from 20 percent in the July-to-September 2013 period to 15 percent in the April-to-June 2014 period. An estimated 9.5 million fewer adults were uninsured. Young men and women drove a large part of the decline: the uninsured rate for 19-to-34-year-olds declined from 28 percent to 18 percent, with an estimated 5.7 million fewer young adults uninsured. By June, 60 percent of adults with new coverage through the marketplaces or Medicaid reported they had visited a doctor or hospital or filled a prescription; of these, 62 percent said they could not have accessed or afforded this care previously.
QuickTake: Number of Uninsured Adults Continues to Fall under the ACA: Down by 8.0 Million in June 2014
The Urban Institute’s Health Reform Monitoring Survey (HRMS) has been tracking insurance coverage since the first quarter of 2013. This QuickTake reports on how the uninsurance rate changed through early June 2014. These results track changes in coverage following the Affordable Care Act’s (ACA) first open enrollment period, which ended on March 31, 2014.
Analysis of data from the June 2014 HRMS shows the uninsurance rate for nonelderly adults (age 18–64) was 13.9 percent (95% CI [12.3, 15.4]) for the nation in June, a drop of 4.0 percentage points (95% CI [2.6, 5.5]) since September 2013, the month before the ACA’s initial open enrollment period began. This represents a drop of 22.3 percent in the uninsurance rate, which translates to a net gain in coverage for about 8.0 million adults (95% CI [5.1 million, 10.8 million]), extending the coverage gain of 5.4 million (95% CI [3.2 million, 7.6 million]) that was found as of early March 2014.1 Though estimates of the size of the net gain in coverage vary across surveys, there is consistent evidence of ongoing gains in insurance coverage under the ACA.
(More from the Urban Institute Health Policy Center)
Significant decline in uninsured rate across age groups since the end of 2013
The uninsured rate has decreased sharply since the Affordable Care Act’s requirement for most Americans to have health insurance went into effect at the beginning of 2014. In fact, the uninsured rate has dropped by 3.7 points since the fourth quarter of 2013, when it averaged 17.1%.
The decline in the uninsured rate last quarter took place at the start of the quarter. The drop reflected a surge of health plan enrollees in early April, prior to the April 15 extended enrollment deadline for people who had previously experienced technical difficulties with the federal healthcare exchange website. In April and May, the uninsured rate hovered at 13.4%, and it remained at that level in June — clearly indicating that the decline seen since late 2013 has leveled off.
The second-quarter results are based on more than 45,000 interviews with U.S. adults from April 1 to June 30, 2014, as part of the Gallup-Healthways Well-Being Index.
Uninsured Rate Continues to Drop Across Age Groups
Gallup’s quarterly trends show that the uninsured rate dropped by about three points from the fourth quarter of 2013 among each major age group under 65. The uninsured rate in the second quarter averaged 18.7% among 18- to 25-year-olds, 23.9% among 26- to 34-year-olds, and 13.4% among 35- to 64-year-olds.
Given the availability of Medicare and Medicaid benefits, very few seniors report being without health insurance, although the uninsured rate among those 65 and older is now 2.0%, down from 2.8% in the third quarter of 2013.
More 18- to 64-Year-Olds Have Self-Funded Insurance Now Than in 2013
While 18- to 64-year-olds are most likely to have health insurance through a current or former employer (43.5%), more reported having self-funded insurance coverage in the second quarter than did before the healthcare exchanges opened in October 2013. For Americans younger than 65, 20.7% say they have a health insurance plan they or a family member pays for, compared with 16.7% in August-September 2013.
There has also been a slight increase in the percentage who have Medicaid insurance, perhaps because a provision of the 2010 healthcare law expanded the qualifying income levels for Medicaid. Thus, the reduction in the percentage of uninsured Americans has been accompanied by increases in the percentages who now have Medicaid or self-funded insurance, through a government exchange or on their own.
Conclusion from pubhealth.tumblr.com: Obamacare, the ACA, has been a resounding policy success. Let’s spread the word.
By Elizabeth Mendes
Most Americans born into the generations that came after the Baby Boom have gone their entire lives aware that smoking can cause lung cancer. But this fact has not always been well-known – and at one time it wasn’t known at all.
Actually, it wasn’t even until cigarettes were mass produced and popularized by manufacturers in the first part of the 20th century that there was cause for alarm. Prior to the 1900s, lung cancer was a rare disease. Turn-of-the-century changes though, gave way to an era of rapidly increasing lung cancer rates. New technology allowed cigarettes to be produced on a large scale, and advertising glamorized smoking. The military got in on it too – giving cigarettes out for free to soldiers during World Wars I and II.
Cigarette smoking increased rapidly through the 1950s, becoming much more widespread. Per capita cigarette consumption soared from 54 per year in 1900, to 4,345 per year in 1963. And, lung cancer went from rarity to more commonplace – by the early 1950s it became “the most common cancer diagnosed in American men,” writes American Cancer Society Chief Medical Officer Otis Brawley, M.D., in an article published November 2013 in CA: A Cancer Journal for Clinicians.
However, though tobacco usage and lung cancer rates increased in tandem, few experts suspected a connection, according to Brawley and his co-authors.
From American Cancer Society
One map that puts America’s gun violence epidemic in perspective
When it comes to gun ownership, the US blows the rest of the world out of the water. And the research on guns suggests that’s probably contributing to our gun murder problem — one that the 74 school shootings that have happened since Sandy Hook demonstrate isn’t yet under control.
Here’s a map of firearm ownership around the world, using 2012 data compiled by The Guardian. The United States has nearly twice as many guns per 100 people as the next closest, Yemen — 88.8 guns per 100 as opposed to 54.8 in Yemen.
(From The Pew Charitable Trusts)
CDC urges vaccination as summer travel season approaches
Two hundred and eighty-eight cases of measles were reported to the Centers for Disease Control and Prevention (CDC) in the United States between Jan. 1 and May 23, 2014. This is the largest number of measles cases in the United States reported in the first five months of a year since 1994. Nearly all of the measles cases this year have been associated with international travel by unvaccinated people.
“The current increase in measles cases is being driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the United States and spread to others in communities where many people are not vaccinated,” said Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases. “Many of the clusters in the U.S. began following travel to the Philippines where a large outbreak has been occurring since October 2013.”
Of the 288 cases, 280 (97 percent) were associated with importations from at least 18 countries. More than one in seven cases has led to hospitalization. Ninety percent of all measles cases in the United States were in people who were not vaccinated or whose vaccination status was unknown. Among the U.S. residents who were not vaccinated, 85 percent were religious, philosophical or personal reasons.
The large number of measles cases this year stresses the importance of vaccination. Healthcare providers should use every patient encounter to ensure that all their patients are up to date on vaccinations; especially, before international travel.
The United States and Mexico are now effectively tied for a top spot nobody really wants — most obese in the developed world.
According to the Organisation for Economic Co-operation and Development (OECD), both populations are edging the 70 percent mark for citizens who are considered overweight or obese.*
(From PBS Newshour)