News: More Americans Are Uninsured Now Than in 2016

News: More Americans Are Uninsured Now Than in 2016

About 3.2 million fewer Americans have health insurance, finds the latest Gallup and Sharecare data.

In the past year, the percentage of American adults without health insurance increased 1.3 percent—which is equivalent to approximately 3.2 million Americans, according to a January 2018 report by Gallup and Sharecare. The 1.3 percent increase is the largest single-year increase measured since Gallup and Sharecare began tracking this data in 2008, even prior to the time period when the Affordable Care Act (ACA) went into effect.

This research was conducted via telephone survey and was comprised of 25,072 American adults aged 18 and older. The survey took place between October 1 and December 31, 2017 as part of the Gallup-Sharecare Well-Being Index.

Uninsured rates rise in nearly every group
Aside from adults aged 65 and older—since the majority of senior citizens receive health coverage through Medicare—the rate of uninsured Americans rose among every demographic group. The largest growths were seen among blacks, Hispanics, young adults and low-income Americans.

Black and Hispanic adults were shown to have the highest rates of increase in 2017, at 2.3 and 2.2 points. The total number of young adults and low-income adults without health insurance grew by 2.0 points, followed by middle-income Americans at 1.4 points and high-income Americans at 0.8 points.

It’s important to note that young adults—those aged 18 through 25—play a vital role in healthcare markets because their limited use of healthcare helps offset the higher costs of insuring older, more vulnerable Americans.

Fewer people bought their own insurance in 2017
Also, the percentage of people who purchase their own health insurance plans, most likely through ACA healthcare exchanges—as opposed to those who receive coverage from an employer, a union, the military, Medicare or Medicaid—is on the decline, dropping from 21.3 percent at the end of 2016 to 20.3 percent in December 2017.

In fact, this decrease indicates a reversal of the trend that began in the third quarter of 2013—when the number of uninsured reached its peak at 18 percent, which was also when the ACA's individual mandate took effect.

Why the decline?
A few marketplace factors most likely contributed to this decline. Some insurance companies did not offer insurance through the exchanges, driving up the cost of the remaining plans. As a result, Americans who failed to qualify for federal subsidies may have opted to go without coverage.

Another factor: Congressional Republicans made several attempts to repeal or replace the healthcare law throughout the year. This may have caused confusion among consumers; leaving them to wonder if the government would really charge a penalty for being uninsured. In December 2017, President Donald Trump signed a tax bill into law that repealed the individual insurance mandate.

Advertising and the ACA marketplace
The number of uninsured Americans fell consistently from 2014 to 2016. But the number of uninsured Americans started to increase in 2017. It was during this time that the Trump administration decreased the advertising budget that promoted the enrollment period on the ACA exchanges by 90 percent. The administration also decreased the number of days within the enrollment period.

Nevertheless, nearly as many people signed up for health insurance on the ACA marketplace for 2018 as they did in 2017.

Uninsured rate in young people expected to rise
The rates of uninsured Americans will likely continue to increase since adults are no longer required to have health insurance, as indicated in the new tax bill. Premiums are also expected to rise, which will further add to this trend, along with the fewer number of younger adults being insured, which will in turn no longer help offset the higher costs of older adults.

Next Up: Reform funding for Medicaid and Medicare
The congressional Republicans legislative goals for the coming year include reforming funding mechanisms for Medicaid and Medicare—government programs that subsidize healthcare coverage for low-income, disabled and elderly Americans. Less federal funding for these types of programs will likely mean fewer people with coverage.

Medically reviewed in January 2018.

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