In reversal, uninsured rate ticks up among US adults, Gallup finds

The percentage of U.S. adults without health insurance rose to 12.3 percent in the third quarter (Q3) of 2017—up 1.4 percentage points since the end of 2016, according to a Gallup-Sharecare Well-Being Index survey released Friday.

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The survey is based on telephone interviews with a random sample of 45,743 U.S. adults conducted from July 1 to Sept. 30 as part of the Gallup-Sharecare Well-Being Index.

Findings

Uninsured rates

According to the survey, the number of uninsured U.S. adults grew by 3.5 million between the end of 2016 and Q3 2017. According to the poll, the U.S. uninsured rate grew by 0.6 percentage points between the second quarter of 2017 and Q3 2017.

The survey found that, since the end of 2016, the U.S. uninsured rate has increased across all key demographics by at least one percentage point. According to the survey, growth in the number of uninsured U.S. adults has been mostly concentrated among middle-aged U.S. residents, racial minorities, and lower-income U.S. residents.

Specifically, the survey found that since of the fourth quarter (Q4) of 2016, the uninsured rate increased by:

  • 1.8 percentage points among U.S. residents ages 35 to 64;
  • 1.5 percentage points among U.S. residents ages 18 to 25; and
  • 1.4 percentage points among U.S. residents ages 26 to 34.

In terms of race and ethnicity, the survey found the uninsured rate from Q4 2016 to Q3 2017 increased by:

  • 1.6 percentage points among Hispanic U.S. adults;
  • 1.5 percentage points among non-Hispanic black U.S. adults; and
  • 1.1 percentage points among non-Hispanic white U.S. adults.

In addition, the survey found the uninsured rate between Q4 2016 and Q3 2017 increased by:

  • 1.7 percentage points among U.S. adults with annual household incomes less than $36,000;
  • 1.3 percentage points among U.S. adults with annual household incomes between $36,000 and $90,000; and
  • 1.1 percentage points among U.S. adults with annual household incomes higher than $90,000.

According to the poll, the uninsured rate among U.S. adults is now the highest it's been since the fourth quarter of 2014, when it reached 12.9 percent. However, Gallup-Sharecare said the current uninsured rate is lower than the peak rate reached in Q3 2013, before the Affordable Care Act's (ACA) coverage expansions took effect—when 18 percent of U.S. residents did not have health coverage.

Types of health coverage

According to the survey, fewer U.S. adults have purchased their own health plans since the end of 2016. The survey found that the share of U.S. adults who had a self-paid plan fell from 21.3 percent in Q4 2016 to 20 percent in Q3 2017—representing a reversal of a previous trend in which self-paid plans had become the fastest growing type of health coverage since the ACA's individual mandate took effect in Q3 2013, according to Gallup-Sharecare.

The survey also found that from Q4 2016 to Q3 2017, enrollment among U.S. adults ages 18 to 64 declined by:

  • 0.5 percentage points for Medicare;
  • 0.4 percentage points for current or former employer-sponsored health plans; and
  • 0.2 percentage points for other forms of coverage.

According to the survey, enrollment among U.S. adults in Medicaid coverage increased by 0.5 percentage points from the end of 2016 to Q3 2017.

Gallup-Sharecare predicted that the number of U.S. residents without health insurance "likely will continue to rise" if Congress and President Trump do not take action "to stabilize the insurance markets."

Reaction

Some health care experts said the Gallup-Sharecare survey's results are in line with other recent findings on the U.S. uninsured rate.

Matthew Buettgens, a senior research analyst at the Urban Institute's Health Policy Center, said, "The results make sense and they track with the results of other rapid surveys."

Gail Wilensky, a health economist who served as CMS administrator under former President George H.W. Bush, said, the survey's results seem reasonable, but said larger government surveys tend to dig deeper into the issue, CBS News reports.

However, Larry Levitt, a senior vice president at the Kaiser Family Foundation, in a series of tweets Friday expressed concerns that the survey results should be viewed cautiously. "The number of people uninsured is likely growing, but there are reasons to be cautious of these new Gallup results," Levitt wrote. He added, "Gallup finds the % of non-elderly with Medicare is down a lot (probably not true) and the % with Medicaid is up (also probably not true)." Levitt concluded, "We should definitely be concerned that the number of uninsured may be growing once again, but the Gallup survey probably overstates things" (Mangan, CNBC, 10/20; AP/CBS News, 10/20; Young, HuffPost, 10/20; Gallup-Sharecare Well-Being Index survey, 10/20; Levitt tweet (1), 10/20; Levitt tweet (2), 10/20; Levitt tweet (3), 10/20; Levitt tweet (4), 10/20).

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