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Uninsured rate continues to fall; some question how many have paid premiums

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The number of uninsured in the United States dropped to 13.4 percent in April, according to a new Gallup poll published today. This is the lowest uninsured rate since Gallup began tracking uninsured rates among U.S. adults in January 2008. The percent of Americans without health insurance hit its highest point, 18 percent, during the third quarter of 2013.

The sharp decline in the uninsured rate coincides with the opening of the Affordable Care Act (ACA) health insurance exchanges last October. The rate continued to drop through the winter and into the spring. The first open enrollment period for individuals closed March 31. Those who began the process of applying for a health plan prior to the end of the enrollment period were allowed to complete their applications, which added a surge of new enrollees during the Special Enrollment Period of April 1 through April 19 the total number of enrollees topped out at over 8 million.

The Gallup findings are based on more than 14,700 interviews conducted between April 1 and April 30. Pollsters asked poll participants, “Do you have health insurance coverage?” Blacks were the demographic with the largest drop in their uninsured rate, with a decrease of 7.1 percent since the end of 2013. Hispanics and young adults also reported having insurance coverage at greater rates.

Gallup research finds that, on average, states that elected to expand Medicaid coverage have lower rates of uninsured citizens. Gallup speculates that as the fines for not having health insurance increase in coming years, the uninsured rate will decline further. Additionally, a provision of the ACA that requires large employers offer employees health insurance benefits goes into effect in 2015. This most likely will contribute to further lowering the rate of uninsured Americans.

While the ACA appears to be accomplishing the goal of increasing the number of Americans that have access to health care, some have questioned how many individuals and families actually have paid their first premium, which would put a policy in force. An April 30 report released by the House Energy and Commerce Committee puts the rate of payment at 67 percent. The Committee report surveyed insurance providers that offered policies on the federal exchange and only included data through April 15.

Because many of the sign-ups came at the end of the open enrollment period, nearly 40 percent of enrollees were not required to make their first premium payment until April 30. Generally, policyholders are not required to pay their first premium until the day before a policy takes effect. An analysis by Charles Gaba of data provided by insures found that 93 percent of policyholders have paid their first premium. The next enrollment period opens Nov. 15, 2014.

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