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Uninsured Rate among Working Adults Rises to 15.5% in 2018

The uninsured rate of working adults increased in the opening months of 2018 as incentives in the Affordable Care Act to acquire insurance weakened.

Uninsured rate among working adults rose to 15.5 percent

Source: Thinkstock

By Thomas Beaton

- The uninsured rate of working adults ages 19 to 64 rose by more than 3 percent between 2016 and 2018, according to the Commonwealth Fund’s ACA Tracking Survey.

In 2016, 12.2 percent of working adults lacked health insurance.  During the first few months of 2018, that number rose to 15.5 percent.

The Commonwealth Fund suggested that federal actions such as the repeal of the individual mandate, encouraging the expansion of short-term health plans, and other changes that weaken the individual health plan market, drove enrollment decreases in the opening months of 2018.

Low income earners were more likely to be uninsured than higher earners, the survey found.

Adults that earned incomes below 250 percent of the federal poverty level represented 25 percent of all uninsured people. Only 5 percent of all uninsured adults earned 250 percent above the FPL.

An annual income that is 250 percent of FPL is about $31,150 for an individual and $61,500 for a family of four.

Medicaid expansion helped to lessen uninsured rates within states, the team found. The 19 states that did not expand Medicaid for 2018 experienced a sharper increase in uninsured rates than states that expanded Medicaid.  

The states that did not expand Medicaid had an average working adult uninsured rate of 21.9 percent. States that expanded Medicaid had an uninsured rate of 11.4 percent within adult groups.

Seventeen percent of adults between 19-34 were uninsured and 17.7 percent of adults ages 35-49 were uninsured. The survey found that 12.3 percent of adults ages 50-64 were uninsured.

The repeal of the individual mandate likely had a profound effect on the observed increase in uninsured individuals, the report suggested.

“Among adults with insurance coverage, 9 percent of those who got their insurance through the individual market, 5 percent of those with employer coverage, and 5 percent of those with Medicaid said they intended to drop insurance because of the repeal,” the researchers stated.

Maintaining steady health plan enrollment rates requires policies that secure payer participation in the individual market, improve health plan affordability, and provide financial support of health insurance market, the team asserted.

The team urged Congressional lawmakers to pass bills that establish reinsurance programs, reinstate federal cost-sharing reduction (CSRs), and expand Medicare into private health plan markets to help increase affordable insurance options.

“More broadly, leaving policy innovation to states will ultimately lead to a patchwork quilt of coverage and access to healthcare across the country, a dynamic that will fuel inequity in overall health, productivity, and well-being,” the team concluded.

“At some point, Congress will likely face pressure to step in to level the playing field.”


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