Is Obamacare Covering the Uninsured? Maybe—But Not As Much as the Administration Says


Is Obamacare reducing the number of uninsured? The Obama administration, demonstrating its typical commitment to transparency and administrative details, says it's not tracking that information systematically. So we have to rely on independent sources of information.

A survey last week from consulting firm McKinsey made big headlines when it found that only about 27 percent of people signing up for private coverage under the law—both within the exchanges and through other means—were previously uninsured. Supporters of the health law weren't too thrilled with that finding, but they're happier with new survey results from Gallup, which suggest that, in just two months, the law has reduced the uninsured rate from 17.1 percent at the end of 2013 to 15.9 percent this year.


This indeed the best evidence that Obamacare is having some effect on reducing the percentage of uninsured. It's a robust survey that collects data from 500 people, almost every day of the year, and it's the second month in a row that Gallup's poll has found a drop.

But what we want to know in order to gauge the law's success isn't simply whether Obamacare is having any effect on reducing the uninsured rate at all. We also want to know how big that effect is, and from what baseline we're measuring.

Part of the reason the recent drop looks as big as it does is because there was a significant, unusual uptick in the uninsured during the second half of last year. It's not entirely clear what caused that spike, although cancellations resulting from Obamacare are probably part of the story. But the uninsured rate has fallen from its peak and now only about a half percent below where it was in 2010 and 2011, the two years after the health law passed.

Still, it's clearly falling. But how significant is the drop? Even measured against the fourth-quarter 2013 baseline of 17.1 points, you're not looking at a huge number of people. That 1.2 percentage point reduction is equal to about 3 million people. And that's the total coverage increase—private plans inside and outside the exchanges as well as the Medicaid expansion.

That's a lot smaller than the numbers that the White House has been touting. Near the end of February, the administration said that 4 million people had signed up for coverage in the exchanges, and that 9 million people had been judged eligible for Medicaid. Now, we already know that those numbers are inflated for a variety of reasons. About 20 percent of private-plan exchange sign ups haven't paid. And the majority of those deemed Medicaid eligible were already covered by the program.

So it could well be that Gallup's numbers are basically on the money, and so are McKinsey's. Which would mean that instead of the 13 million people the administration the administration counts as having obtained coverage under the law, the total gain in coverage for the previously is really more like 3 million, most of which comes through the dysfunctional Medicaid system. If so, that's not nothing, but it's a lot less than most anyone who supported the law predicted or hoped. 

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  1. I wonder if they’re tracking people like me, who HAD insurance, and now don’t.

    Thanks Obamacare!

    1. I will be joining you on May 1. I think there are a lot of us out there.

      1. I dropped med insurance for a few months due to ObamaCare, but signed up for coverage to start in April.

        If one games the system, one can pretty much get full ObamaCare insurance coverage and only pay premiums for nine months out of the year.

        1. You’re still getting fucked.

    2. You had fake insurance and didn’t know it!


    3. They’ll count you the second you get new insurance.

      1. Which I won’t be doing.

  2. I realize that the chart is Gallup’s, not Reason’s, but it’d be really nice to see a version with a longer timescale. In this chart, 15.9% uninsured seems like an impressively low number. But, it’s only impressive when compared to the history of the current administration.

    1. here’s ’87 to ’08


      1. And a prediction from a CBO source in 2012:


        1. Well, since that massive drop hasn’t happened:


          1. Insurance policies saved or created?

            Of course, the only stat worth that indicates any market improvement under the system is the net increase in unsubsidized insureds who pay for their own policies. A silver plan in Texas for couple of late-50s geezers goes for $17,400 ($6000 oop cap). I imagine that lots of folks will opt for the penaltax.

            Any other stat is just a measure of how many new welfare recipients the ACA has created.

  3. When they found out that this shit really wasn’t free, most of these people didn’t even bother.

    1. That’s basically it.

  4. Let them do another poll (where are the real numbers?) in a few months. I’m sure there are a few million out there like me who are still on their old plan but won’t get new insurance because it costs too damned much. My old plan expires at the end of the month and I’ll be without health insurance. They picked this time in particular because this is the time at which the numbers will look their absolute best. And they’re still shitty.

  5. It’s a robust survey that collects data from 500 people, almost every day of the year, and it’s the second month in a row that Gallup’s poll has found a drop.

    What is the expected standard error of a survey of 500 persons, at least 3 percent? The change is indistinguishable from the noise of the survey, putting aside whatever variation is really going on in the underlying population. Adding a decimal place to the numbers should draw guffaws – really what is this bs?

    1. It is 500 people a day with the data points appear to be monthly so it is actually 500*~30 or around 15,000 surveyed for each datapoint, course that would still have a margin of error somewhere around 1.5% meaning they haven’t really moved past the noise ratio yet.

    2. According to Gallup link, the error rate is +/- 1% at 95% confidence, so a “drop” 17.1% to 15.9% is essentially statistically meaningless.

  6. We can at least be sure that Obamacare isn’t covering the un-alt-texted.

  7. I would love to see the cost differential between ACA and just paying for insurance for the 1.5 million or newly insured.
    Progs complain about the overhead of Korporashuns with a marketing budget but pay no mind to the “efficiencies” of scale a huge bureaucracy brings to the table just trying to give away money.
    As much time is spent pointing out their lust for control and other people’s money, I don’t think enough time is spent on their insane obsession with the greatness of a ponderous Leviathan that no one can effectively steer, let alone comprehend. Saying, “Economies of Scale” makes them cream their pants and shut off their brains.

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