An average of 12.9% of U.S. adults were uninsured during the fourth quarter of 2014, down significantly from 17.1% a year ago and 13.4% from last quarter, according to the Gallup-Healthways Well-Being Index. The fourth-quarter result is the lowest rate recorded by the index since it began tracking the uninsured rate in 2008.
The uninsured rate has dropped 4.2 percentage points since the individual insurance mandate of the Patient Protection and Affordable Care Act went into effect in 2014.
Uninsured rates have fallen most heavily among blacks and low-income individuals; 13.9% of blacks reported they were uninsured during the fourth quarter, down 7 percentage points from the same time the prior year. The uninsured rate for individuals who make less than $36,000 a year was 30.7% during the fourth quarter, down 6.9 points from 2013.
Hispanics, who have been a major focus of the Obama administration's efforts to enroll minorities, continue to represent the highest population of uninsured individuals; 32.4% of Hispanics said they were uninsured, a drop of 6.3 percentage points from the prior year.
The demographic group with the highest percentage of uninsured members is 26- to 34-year-olds, with 22.6% reporting that they are uninsured, down 5.6 percentage points. The ACA requires insurers to allow children to be covered under their parents' insurance until they're 26 years old. The uninsured rate for 18- to 25-year-olds hit 17.4%, down 6.1 percentage points from 2013.
The only age group for whom the uninsured rate didn't change is Americans 65 and older, likely because most of those individuals are covered by Medicare. That rate remains at 2%.
The index also asks how Americans are gaining coverage. Roughly 2 in 5 Americans, about 43.4%, have coverage through their employers, while 20.6% have self-funded insurance.
The number of individuals covered by their employers has decreased only slightly since the fourth quarter of 2013, though the number of Americans who have self-funded plans has increased 3 points, likely the result of increased enrollment on HealthCare.gov, where 6.5 million Americans have either selected new plans or were automatically re-enrolled as of Dec. 26.
Starting this year, businesses with 100 or more employees are required to provide health insurance to most of their workers or face a penalty, which means the uninsured rate may drop further. In 2016, the mandate will go into effect for businesses with 50 or more employees.
The rate also could fall as more states expand Medicaid. Gallup has found that states that have chosen to expand their Medicaid programs and set up their own exchanges have seen lower rates of uninsured residents.
Harris interviews 500 people daily for the index. The fourth-quarter rate was calculated from interviews with more than 43,000 Americans from Oct. 1 to Dec. 30. The current open enrollment period began on Nov. 15.
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