The rate and number of insured Americans reached historic highs in the years following passage of the Affordable Care Act (ACA). In a new report, researchers from the Urban Institute — with funding from the Robert Wood Johnson Foundation — provide a granular perspective on the 19 million people who gained coverage (2010-2015) and where they live.
Coverage rates increased broadly across age, gender, race/ethnicity, education, and state. The Urban researchers found that a large share of the nonelderly adult coverage gains occurred among those without a college degree – 87 percent. Fifty-seven percent of the children and adults gaining coverage were nonwhite or Hispanic.
"In recent years we have seen unprecedented gains in health insurance coverage,” said Kathy Hempstead of the Robert Wood Johnson Foundation. "What happens next is uncertain, and the ability to maintain these gains will undoubtedly be a central issue for policymakers to consider.”
The report includes state-by-state breakdowns by key demographics to illustrate who gained coverage under the law. Highlights include:
- Among nonelderly adults gaining coverage, 14.1 million did not have a college degree; within this group, 44 percent were non-Hispanic white
- In California, 3.8 million people gained coverage and the uninsured rate dropped 53.4 percent after state policymakers expanded Medicaid eligibility
- In Florida and Texas, 3.2 million people gained coverage, even though these two Southern states chose not to expand Medicaid
- In Illinois, Michigan, Ohio, and Wisconsin, more than 2.3 million people gained coverage – accounting for a 38 to 49 percent drop in the percentage of people without health insurance across these Midwestern states.
