ACA Coverage Gains Include Workers Without Insurance

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The self-employed and wage earners without insurance offers had insurance gains equal to or greater than those of people not employed.
The self-employed and wage earners without insurance offers had insurance gains equal to or greater than those of people not employed.

HealthDay News — After the expanded coverage provisions of the Affordable Care Act (ACA) were implemented in 2014, self-employed individuals and wage earners without employer-sponsored health coverage offers had coverage gains equal to or greater than those of people not employed, according to a report published in the August issue of Health Affairs.

Sandra L. Decker, from the Agency for Healthcare Research and Quality in Rockville, Md., and colleagues used data for 2010 to 2016 from the National Health Interview Survey to analyze changes in insurance status after the ACA for those not employed compared with workers, including the self-employed and wage earners with and without employer coverage offers.

The researchers found that the self-employed and wage earners without insurance offers had insurance gains (reductions in uninsurance rates) equal to or greater than those of people not employed. After 2014, when the ACA's major coverage provisions were enacted, the percentage of not-employed adults who were uninsured declined by 6.9 percentage points. These reductions in uninsurance were similar for self-employed workers (6.7 percentage points) but much larger for wage earners without employer coverage offers (17.3 percentage points).

"Health insurance expansions have the potential to disproportionately benefit workers who have historically experienced relatively low rates of insurance coverage," the authors write.

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