WASHINGTON, D.C. -- The U.S. uninsured rate declined to 17.1% in the fourth quarter of 2013 from a six-year high of 18.0% in the third quarter. It now matches the uninsured rate found in the second quarter of 2013. This marks the first drop in the uninsured rate since the end of 2012.
These data were collected in the fourth quarter of 2013, after the health insurance exchanges required under the Affordable Care Act opened on Oct. 1, but before newly purchased health insurance plans became effective on Jan. 1, 2014.
The uninsured rate is considerably higher today than when Gallup and Healthways began monitoring U.S. adults' health insurance coverage daily in January 2008 as part of the Gallup-Healthways Well-Being Index. The rate was around 14.5% in 2008 and it generally increased until the end of 2011, when it was 17.5%. It declined throughout 2012, but rose again in the first three quarters of 2013.
Young Adults Still Seem to Benefit From Healthcare Law
Young adults have the highest uninsured rate of any age group Gallup tracks. However, the percentage of uninsured 18- to 25-year-olds has been lower since the provision in the new healthcare law allowing this age group to remain on their parents' plans went into effect in September 2010. As a result, this youngest age group is the only age group to experience a decline in the percentage who are uninsured since Gallup began tracking health insurance status daily in 2008.
Very few Americans aged 65 and older, almost all of whom are eligible for Social Security, are uninsured, with the average uninsured rate among the remainder of the population -- those aged 26 to 64 years -- now at about 20%.
Nearly Half of Americans Have Health Insurance Through an Employer
When asked what type of primary health insurance coverage they currently have, 45.6% of insured Americans say their plan is through a current or former employer. Two in 10 Americans (20%) currently have Medicare, 11% have a different type of plan paid for by the government (Medicaid, military or veterans' insurance), while 17.2% have a plan fully paid for by themselves or a family member.
Gallup and Healthways modified the question they ask about the type of plan Americans have in August 2013, leading up to the opening of insurance exchanges in October. The fourth quarter, thus, is the first full quarter in which Gallup has data on insurance type using the new categories. These new results serve as a baseline to measure changes in the type of coverage people have as more uninsured Americans enroll in coverage using insurance marketplaces implemented through the Affordable Care Act.
Implications
Health insurance plans purchased through health insurance exchanges did not take effect until Jan. 1, 2014, but Americans began signing up for plans starting Oct. 1, 2013. Though the Healthcare.gov website has experienced technical difficulties that impeded many uninsured Americans from purchasing their plans before the initial Dec. 24 deadline (which was extended through Dec. 28), the White House reports more than 6.6 million Americans enrolled in coverage through the exchanges or through the Medicaid expansion as of Jan. 1. The number of previously uninsured Americans who now have coverage through the exchanges is unknown.
Much of the commentary surrounding the new healthcare law's success is about young adults signing up for health insurance through the exchanges due to the large number of uninsured young Americans. The White House and HHS reported that, as of Dec. 28, only 9% of the individuals who have signed up for a plan are 18- to 25-year-olds, while 15% are 26- to 34-year-olds -- making up slightly less than one-quarter (24%) of the total enrollment. This is much lower than the Obama administration's target of 40%.
As more uninsured Americans continue to sign up for health insurance coverage through the insurance exchanges, the uninsured rate will likely continue to decline. Gallup will report next week on how the uninsured rate has changed since new health plans purchased through the health exchanges took effect on Jan. 1.
Editor's Note: The Quarter 2-Quarter 4 data for 2013 in this article reflect a revision of -0.1 points from the original version.
About the Gallup-Healthways Well-Being Index
The Gallup-Healthways Well-Being Index tracks well-being in the U.S. and provides best-in-class solutions for a healthier world. To learn more, please visit well-beingindex.com.
Survey Methods
Results are based on telephone interviews conducted as part of the Gallup-Healthways Well-Being Index survey Oct. 1-Dec. 31, 2013, with a random sample of 42,084 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia.
For results based on the total sample of national adults, the margin of sampling error is ±0.5 percentage points at the 95% confidence level.
Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.
Samples are weighted to correct for unequal selection probability, nonresponse, and double coverage of landline and cell users in the two sampling frames. They are also weighted to match the national demographics of gender, age, race, Hispanic ethnicity, education, region, population density, and phone status (cellphone only/landline only/both, cellphone mostly, and having an unlisted landline number). Demographic weighting targets are based on the most recent Current Population Survey figures for the aged 18 and older U.S. population. Phone status targets are based on the most recent National Health Interview Survey. Population density targets are based on the most recent U.S. census. All reported margins of sampling error include the computed design effects for weighting.
In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.
For more details on Gallup's polling methodology, visit www.gallup.com.
