Number of U.S. Uninsured Falls Once More

Open enrollment on the U.S. public health insurance marketplace ended in mid-January and as of January 7, almost 16 million people had already signed up to receive insurance coverage in 2023. The number is a new record for the enrollment period that happens once a year and constitutes a 13 percent increase over the 2021/22 sign-up, according to a press release by the government.

Enrollment for coverage under the Affordable Care Act - also dubbed Obamacare - is up for the third year in a row. Together with other factors that expanded healthcare coverage, this fact is reflected in the rising number of Americans who have health insurance. In 2019, a high of 33.2 million Americans were uninsured, amounting to 10.3 percent of the population. As of June 2022, that number was down to 27.4 million or 8.3 percent of Americans.

Expansions to Medicaid and the Affordable Care Act were made by the Biden administration as part of the American Rescue Plan, a Covid-19 relief bill passed in March 2021, and were extended in the Inflation Reduction Act of 2022. According to the Kaiser Family Foundation, the introduction of subsidies for applicants earning 400 percent or more of the federal poverty level made ACA coverage more attractive for a lot of workers since the the 2021/22 enrollment period. A 60-year old making just over that poverty level cutoff (around $52,000 per year), for example, formerly could have expected a monthly insurance bill of around $950 or 22 percent or his or her income through ACA. After the change, the premium would be capped at 8.5 percent of that person's income. The same laws mentioned above also extended Medicaid eligibility to new groups, offering health insurance to even more people that are not covered through their employers.

Under the Trump Administration, cutbacks to Medicaid decreased enrollment by 0.7 percent between 2017 and 2018. The elimination of 90 percent of the advertising budget for the ACA's annual sign-up period also resulted in 400,000 fewer enrollments that year, according to CNBC. The number of insured Americans kept rising until 2019, but dropped in 2020 for the first time under Trump - even before the onset of the coronavirus pandemic.

As seen in our chart, the number of uninsured Americans took a major dip after the enactment of Obamacare and the expansion of Medicaid in 2014.