Study: More gain health insurance under Affordable Care Act

WASHINGTON – As congressional Republicans move toward another vote on repealing the Affordable Care Act, new evidence was published Wednesday about the dramatic expansion of insurance coverage made possible by the law.

Nearly 17 million more people in the U.S. have gained health insurance since the law’s major coverage expansion began, according to a study from the Rand Corp., a Santa Monica, California, nonprofit research firm.

That tally takes into account 22.8 million newly insured people and 5.9 million who lost coverage in the past year and a half.

Researchers found gains across all types of insurance, including employer-provided coverage, government Medicaid programs and policies offered through state insurance marketplaces created by the law.

At the same time, the vast majority of Americans have seen no change in the source of their coverage, with 80 percent remaining in the same kind of insurance, researchers found.

“The ACA has greatly expanded health insurance coverage in the United States with little change in the source of coverage for those who were insured before the major provisions of the law took effect,” concluded the authors of the study, published online by the journal Health Affairs.

The Rand study, based on surveys of 1,589 working-age adults, is not as large as other polls. But the findings are consistent with national surveys by Gallup, as well as with data from the federal government, which have all shown a dramatic decrease in the nation’s uninsured rate since the health law’s coverage expansion began.

The biggest growth has been in the marketplaces created by the law, which now have about 11 million adult customers, about a third of whom were uninsured in 2013, according to the study.

Medicaid, another pillar of the health law, has seen enrollment grow by nearly 10 million adults since 2013.

Whether the coverage gains can be sustained remains unclear. The Rand survey shows that increases in insurance slowed this year, compared with 2014.

The insurance gains could also be reversed if congressional Republicans succeed in repealing the health law or if the Supreme Court this summer backs a lawsuit that argues that insurance subsidies provided through the law should not be available in more than 30 states that rely on the federal government to operate their insurance marketplaces.