State Sees 50% Drop in Uninsured Adults

Former Health and Human Services Secretary Kathleen Sebelius and President Barack Obama. Official White House. Photo by Pete Souza.

The Affordable Care Act (ACA) has dramatically reduced the number of uninsured adults, according to new data released by Gallup. A nationwide poll of about 88,000 people during the first 6 months of 2015 found that the percentage of adults who were uninsured dropped to 11.7% this year, compared to 13.4% in the second and third quarters of 2014 and 17.3% in 2013. More specifically, the uninsured rate among adults was 11.9% in the first quarter of 2015 and fell to just 11.4% during the second quarter.

The Gallup polling also includes state-level data, and those figures show especially large improvements in insurance coverage in the states that have expanded Medicaid and have embraced the ACA. The seven states with the largest percentage point gains in coverage (AR, KY, OR, RI, WA, CA, & WV) are all states that have expanded Medicaid and have state-run health insurance marketplaces. (Wisconsin rejected expanded Medicaid coverage and has a federally-run insurance marketplace, because of decisions made by Gov. Scott Walker.)

The new survey data also show a sharp drop in uninsured adults in Wisconsin over the last two years. The polling results suggest that only 5.6% of Wisconsin adults were uninsured in the first half of 2015, compared to 8.4% last year and 11.7% in 2013.

The Wisconsin numbers are very encouraging and reinforce other data indicating that Wisconsin is making a large dent in its uninsured population. (See, for example, this recent analysis from the UW Population Health Institute.) However, the state-level Gallup numbers should be used with caution. The survey sample in Wisconsin included 1,834 people during the first half of this year. That’s a pretty respectable sample size (larger than some political pollsters use), but the survey leaves a margin of error of plus or minus 1 to 2 percentage points for most states (and as much as 4 percentage points in several small states). It’s a big enough sample that we can tell with confidence that coverage in Wisconsin has made substantial gains, but not big enough that we can confidently compare how states are doing (without aggregating them into groups).

In mid-September the Census Bureau will release the first American Community Survey (ACS) data shedding light on the effects of the major changes in the Affordable Care Act. The ACS sample will include nearly 60,000 Wisconsinites, which makes it far more reliable than the Gallup survey. In addition, it applies to people of all ages, whereas the Gallup poll only measures insurance coverage of adults. However, the ACS data will be from 2014 (and won’t fully capture the gains over the course of that year), whereas the Gallup polling already covers the first half of 2015, so it reflects most of the additional growth in Marketplace participation this year.

While we wait for the more precise 2014 estimates from the Census Bureau, it’s already very clear that the ACA has been extremely successful in reducing the number of uninsured Americans, and it seems pretty clear that Wisconsin has also seen a sharp drop in the uninsured. Just how much coverage has improved in Wisconsin and how we compare with other states will come into much clearer focus in mid-September.