The uninsured rate in America is on the rise again according to the 2017 Gallup-Sharecare Well-Being Index, which was conducted from October 31 to December 31. In the last quarter of 2017, the number of Americans without health insurance hit 12.2 percent, which is slightly lower than in the third quarter (12.3 percent) but a significant jump compared to the same quarter of 2016. Then, the uninsured rate had fallen to 10.9 percent. Between last year and now, the uninsured rate increased by 1.3 percent. It’s the largest single-year jump in the uninsured rate since Gallup and Sharecare started tracking these figures in 2008.
Since 2008, when the uninsured rate was 14.3 percent, the overall number of people without health insurance has declined. The uninsured rate hits its peak in 2013 just before the Affordable Care Act’s individual mandate took effect, topping 18 percent. By the first quarter of 2014, it had dropped to 13.4 percent and continued to decline until last year.
Gallup suggests that several factors influenced the spike in uninsured Americans this year, among them confusion over whether the Affordable Care Act is still in effect. Congressional Republicans tried unsuccessfully to repeal former President Obama’s signature healthcare law in the summer of 2017, and many Americans may not have realized that the individual mandate was still in effect or that they had options for signing up for health insurance. Republicans were successful in repealing the individual mandate portion of the law last month when they passed a significant tax reform bill in December. That repeal will take effect in 2019.
Despite fears that the Trump administration’s actions during the open enrollment period this year directly caused the dip in the uninsured rate, Ross Marchand of the Taxpayers Protection Alliance argues otherwise.
He suggests that while a lack of young, healthy enrollees and higher premiums on the individual exchanges in 2017 played a role, these factors alone don’t tell the whole story. Instead, the decline in the uninsured rate comes from young people with moderate health concerns (the “median-healthed person”) who can’t afford the premiums and who believe that the individual mandate will not be enforced this year. The wealthy and the very sick will still continue to purchase health insurance, the one because they can and the other because they must. Poor people tend to save less and value immediate income over long-term investment in a healthcare plan, and this factor may influence the individual market even further in the future as the economic disparity widens on Obamacare exchanges.
The Gallup survey also found that the uninsured rate affected minority populations more than non-Hispanic whites. Between the final quarter of 2016 and the end of 2017, the uninsured rate among blacks and Hispanics increased 2.3 and 2.2 percent, respectively. During the same time frame, the uninsured rate for whites increased by just 0.7 percent.
The youngest adult demographic (18 to 25) and those earning less than $36,000 a year also saw the biggest overall decline in the number of people with health insurance. Gallup noted that 2017 saw a 1 percent decline in the number of people who bought their own health plan compared to the same time last year, most likely due to drop-offs in the ACA marketplaces.