The House hasn’t backed off its call to 'repeal and replace' the health law. More signs of health coverage growth

Millions of Americans have gained health insurance since Obamacare went into effect, according to several new surveys that show the law is bringing down the nation’s uninsurance rate after its “train wreck” of a start.

Three new surveys released in rapid succession Thursday found substantial numbers of newly insured adults. None of those findings will put to rest the political debate about the cost, structure and wisdom of the Affordable Care Act but they do give advocates firm evidence that the law is meeting coverage goals.


The Gallup-Healthways Well-Being index pegged the rate at 13.4 percent among all adults in the second quarter of 2014, the lowest since it began measuring in 2008, and a drop from 17.1 percent at the end of 2013. The Urban Institute estimated that 13.9 percent of adults between 18 and 64 years old lacked coverage in early June, and suggested that 8 million had gained coverage since September.

And a tracking survey by the Commonwealth Fund found that the uninsured rate among working-age Americans dropped from 20 percent at the end of last summer to 15 percent at the end of this spring, with 9.5 million newly insured. Those findings are almost identical to a RAND Corp. study released in April, which found a net gain of 9.3 million insured adults.

When HealthCare.gov crashed and waves of health plan cancellation notices hit consumers last fall, Republicans said their warnings about the law had been vindicated. Even now, questions remain about how many people are paying their premiums — and whether they like the health plans and the care they can access.

The House hasn’t backed off its call to “repeal and replace” the health law, although it hasn’t held recent repeal votes, and even some backers of the leading Obamacare “replacement” bill acknowledge that a vote is unlikely before November’s elections. And as recently as this Tuesday, Senate Republicans took to the floor to highlight complaints of high premiums and narrow networks of doctors.

“What middle-class family can afford to spend $17,000 a year on insurance? How can a small business with one employee afford an $8,000 yearly hike in insurance premiums?” said Sen. John Thune (R-S.D.), concluding a reading of letters from constituents. “The answer is they can’t.”

But the sign-up numbers are providing another dimension to the debate. The Commonwealth survey, for instance, found that 78 percent of self-identified Republicans who had gotten covered were somewhat to very optimistic that it would improve their ability to get needed health care.

Because of decisions states have made, the remaining insured are more likely to live in “red” states. The Urban Institute concluded that while the uninsured rate was down to an average 10.1 percent in the states that expanded Medicaid, the average was 18.3 percent in the two dozen states that rejected that approach. Almost all Democratic-led states expanded; GOP governors split.

“Consistent with this change, the remaining uninsured are increasingly concentrated in the non-expansion states,” wrote the Urban Institute analysts.

In addition to declining federal money to expand Medicaid, those states were more likely to have used HealthCare.gov for enrollment instead of setting up their own marketplace. That meant they also left money for outreach and enrollment assistance on the table.