Covered Up

Obamacare and the insured


A June survey by the Kaiser Family Foundation found that more than half—57 percent—of those enrolled in coverage through Obamacare's exchanges were previously uninsured. The finding was a marked improvement over previous independent surveys from consultants at McKinsey and RAND, which found that 24 percent and 36 percent, respectively, of post-Obamacare enrollees were previously uninsured. (Differing methodologies account for some of the variation.) The survey provides solid evidence that a majority of the people covered through the law's exchanges were not insured before.

But it also suggests some limits to Obamacare's coverage scheme. More than 40 percent of exchange enrollees were already insured, indicating that while Obamacare is expanding coverage, it is also resulting in a fair amount of subsidized benefits going to people who already had coverage. (The vast majority of exchange beneficiaries got subsidies.)

The survey also hints at the difficulty in measuring who exactly counts as previously uninsured. If someone had health insurance up until a month prior to getting new coverage under the law, should that person count as uninsured? Probably not. What about six months before? Or a year before?

Kaiser's survey finds that the majority of previously uninsured lacked coverage for two years, and that 45 percent reported not having coverage for five years. So more than half of the previously uninsured were covered at some relatively recent point.

Many of those people clearly were having difficulty getting coverage for some reason-perhaps as a ripple effect of the recession, perhaps because of some other factor. But many of them appear not to be completely uninsurable. They are not people who couldn't get insurance under any circumstance; they're just people who didn't have it recently.