Four studies published in mid-August indicate that the Affordable Care Act is achieving its goal of reducing the number of Americans without health insurance while having no negative impact on jobs or labor force participation.
The studies were released by the Urban Institute in partnership with the Robert Wood Johnson Foundation; the National Center for Health Statistics of the Centers for Disease Control and Prevention; the Centers for Medicare & Medicaid Services; and Gallup, Inc.
The Urban Institute study which asks “Has the ACA Been a Job Killer?”, examined data from January of 2000 to December of 2014, looking at labor supply, labor force participation, employment, part-time employment, and hours worked per week.
“We find that the ACA had virtually no adverse effect on labor force participation, employment, or usual hours worked through per week 2014,” the study concludes. This was true both for ACA policies overall and for Medicaid expansion states.
Adult employment in 2014 was actually slightly higher – by 1.8% – than statistical trends would have predicted. Part-time employment was 0.5% higher than trends would have predicted, but this likely resulted from the recovery in the labor market.
Labor force participation fell from about 79% of the non-elderly adult population in 2000 to about 75% at the end of 2014. The expected rate of participation closely tracked the actual rate, with changes caused largely by economic conditions, including the Great Recession of 2008-2011. Similarly, the ratio of employment to population also was virtually the same as projected.
Just under 8% of the working-age population had part-time jobs in 2000, according to the study. That figure held fairly steady through 2008, then jumped to almost 10% during the recession, declining to about 9.5% at the end of 2014.
Hours worked per week were 40 in 2000. That declined by about half an hour prior to the recession, then fell to about 38.5 hours by 2010. Since then it has recovered to about 39 hours.
The CDC’s 27-page statistical analysis shows that the percentage of adults 18 to 64 years of age who were uninsured fell from about 20% in 1997 to 13% in March of this year. Among children under 18, the percentage without insurance decreased from about 15% in 1997 to 4.6% in March.
According to a fact sheet issued by the Centers for Medicare & Medicaid Services (CMS), the ACA is performing well at providing a safety net for those who lose their health insurance because of “life changes,” such as loss of a job.
The agency looked at 944,000 individuals who because of life changes were eligible to sign up for coverage on a Marketplace between February 23 and June 30 of this year, outside of the normal enrollment period. Of these, 50% had lost their coverage because they lost their jobs or for other reasons.
A Gallup survey found that currently only one state, Texas, has an uninsured rate of more than 20%, compared to 14 states in 2013, when implementation of the ACA began.
In 2013 only five states had uninsured rates of 10% or less, while today that is true for 26 states.
Among the states that have had the sharpest decline in their uninsured rates are Arkansas, which reduced its rate from 22.5% in 2013 to 9.1% at mid-2015; Kentucky, from 20.4% to 9.0%; Oregon, 19.4% to 8.8%; Washington, from 16.8% to 6.4%; and Rhode Island, 13.3% to 2.7%.
No state has reported a statistically significant increase in the percentage of uninsured compared to 2013, Gallup noted. Nationwide, according to their survey the uninsured rate in June of this year was 11.7%.
