Gaining Coverage In 2014: New Estimates Of Marketplace And Medicaid Transitions

Gaining Coverage In 2014: New Estimates Of Marketplace And Medicaid Transitions

New AHRQ Studies Examine Insurance Enrollment Gains

Two AHRQ studies published in the October issue of Health Affairsprovide new insights into transitions in insurance coverage between 2013 and 2014:

• About 72 percent of non-elderly adults who enrolled in a Marketplace plan in 2014 were uninsured at some point between January 2013 and the month before they enrolled. The analysis also showed that, among people who had been continuously uninsured in 2013, those who lived in states that expanded Medicaid were more than three times as likely to obtain Medicaid coverage in 2014 as those in non-expansion states. These findings emerged from newly available national data about insurance changes for non-elderly adults from January 2013 through December 2014. Access the abstract for the study, “Gaining Coverage in 2014: New Estimates of Transitions to Marketplace and Medicaid Coverage.”
• People who gained insurance coverage in 2014 after being uninsured the previous year were far more likely than those who remained uninsured to gain a usual source of care and access to preventive health services. Among those newly insured, 27 percent of those with Marketplace coverage and 18 percent of those with Medicaid gained a usual source of care compared with 11 percent of those who remained uninsured. These data indicate that people who gained insurance in 2014 experienced greater improvements in their access to care than those who remained uninsured. Access the abstract for the study, “Access To Care Improved For Those Who Gained Medicaid Or Marketplace Coverage In 2014.”

The new AHRQ studies help to quantify shifts in insurance coverage following passage of the Affordable Care Act. Both studies were based on data from AHRQ’s Medical Expenditure Panel Survey (MEPS) – Household Component. MEPS is a nationally representative survey that collects information on Americans’ health insurance, health care use and spending, access to care and other characteristics. Access previous MEPS statistical briefs on these topics.

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Gaining Coverage In 2014: New Estimates Of Marketplace And Medicaid Transitions

1. Jessica P. Vistnes1,* and 
2. Joel W. Cohen2

+Author Affiliations

1. ¹Jessica P. Vistnes (Jessica.Vistnes@ahrq.hhs.gov) is a senior economist in the Center for Financing, Access, and Cost Trends at the Agency for Healthcare Research and Quality (AHRQ), in Rockville, Maryland.
2. ²Joel W. Cohen is director of the Center for Financing Access and Cost Trends at AHRQ.

1. ↵*Corresponding author

Abstract

We used data from the Medical Expenditure Panel Survey–Household Component to examine coverage transitions for nonelderly US adults. We found that 71.5 percent of Marketplace enrollees in 2014 had some period of uninsurance before enrollment. In Medicaid expansion states, 17.4 percent of adults who were uninsured throughout 2013 gained Medicaid coverage in 2014, compared with only 5.6 percent in those states between 2012 and 2013.