Approximately 16.4 million uninsured Americans have received some type of health coverage since the Affordable Care Act was passed five years ago, government officials reported Monday.
The large drop in those without health insurance indicated that the healthcare law is reaching its intended goals, officials argued. But the law and many of those who gained coverage face an uncertain future because of a pending U.S. Supreme Court case, King v. Burwell, which could upend subsides paid to many of these new policyholders so they could afford to purchase insurance.
“That's quite simply a historic reduction in the uninsured rate,” Dr. Meena Seshamani, director of HHS' Office of Health Reform, said of the 16.4 million figure on a call with reporters Monday.
The drop in the number of uninsured primarily came from the ACA's health insurance exchanges and expansion of Medicaid to people who earned up to 138% of the federal poverty level, according to a report from HHS' Office of the Assistant Secretary for Planning and Evaluation. About 14.1 million adults gained health coverage through those two provisions or through employers.
Another 2.3 million young adults aged 19-25 were able to stay on their parents' health plans until they turned 26 thanks to a provision in the ACA mandating such coverage for them.
Excluding the younger population, the figures are close to a previous nonpartisan projection. In May 2013, the Congressional Budget Office estimated 14 million people (PDF) would gain insurance coverage by 2014. The CBO said that total would rise to 20 million by 2015.
The uninsured rate fell most precipitously among African-Americans and Latinos. The uninsured rate declined 12.3 percentage points for Latinos and 9.2 percentage points for African-Americans. The uninsured rate dropped 5.3 percentage points for whites.
At the end of 2014, about 30 million adults remained uninsured, according to the Kaiser Family Foundation, which noted that nearly half of those were eligible for some kind of ACA assistance. Some of the 30 million were ineligible because of their immigration status or because their state did not expand Medicaid.
About 11.7 million Americans bought or re-enrolled in health coverage through the ACA's exchanges in the most recent open-enrollment period. Nearly 9 of 10 people received subsidies to lower their monthly premiums. Those subsidies are at risk if the Supreme Court rules in favor of the plaintiffs in King v. Burwell.
Justices heard oral arguments for the case two weeks ago; a decision is expected in June.
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