Six out of ten Americans insured through the Affordable Care Act were previously uninsured, according to a new Kaiser Family Foundation survey. Previous investigations of the ACA found much lower proportions of the previously uninsured in the new ACA exchanges. This suggested that the law wasn’t achieving even its own goal of expanding coverage. So at first glance, this new survey is great news for supporters of the law who are looking for evidence that Obamacare is making a dent in the number of uninsured.But once you dig deeper into the data, things get complicated. NYT:
Most of the uninsured had been without coverage for two years or more, and 45 percent said they had been without coverage for at least five years, the foundation said in a report about people in the individual insurance market.A majority of people with new health plans purchased inside and outside the exchanges rated their coverage as excellent or good and said they were generally satisfied. But four in 10 said it was difficult for them to afford their share of the premiums. […]The survey found that people in the individual insurance market had been affected by the health care law in different ways. Thirty-four percent said they and their families had benefited from it; 62 percent said they had not.
In other words, nearly half of those who said they were previously uninsured actually had insurance sometime in the past five years. Whether it’s fair to call these people “previously uninsured” is a hard question, and in fact there are many outstanding questions about what our uninsured population is really like. Perhaps some of these people were between jobs and would soon have gotten insured again. Perhaps they had insurance but could not afford their premiums (a problem unlikely to go away under the ACA). Whatever the reason why they had and then lost insurance within the past five years, this kind of churn complicates the narrative about the ACA’s march to universal coverage.Even more telling is the fact that 62 percent of those surveyed don’t think the law benefited them—even though presumably a good number of that 62 percent were “previously uninsured.” Apparently the American people don’t think just getting insurance is that much of a benefit. With premiums rising year after year, and even people with insurance having problems accessing care, it’s no wonder.