Four percent of Americans tell Gallup they gained health insurance this year, and about half of them say they did so through the Affordable Care Act’s health-insurance exchanges — but that’s a net number, excluding the people who lost insurance for whatver reason. The questions were asked as part of Gallup’s daily tracking poll from March 4 to April 14, encompassing 20,000 Americans.
About 12 percent of people said they got a new insurance policy in 2014, and Gallup says the drop is basically in line with their assessment of changes in the uninsured population. They’ve seen it drop over the last few months, from 18 percent to about 16 percent (this works out since surely some substantial number of Americans lost insurance – 4 percent newly insured, 2 percent newly uninsured).
Gallup’s data point is interesting, but because the sample wasn’t focused on the newly insured, their numbers actually could be way off. Indeed, there has to be something amiss: By their reckoning, 12 million American adults gained insurance this year, which isn’t out of the realm of possibility. But 6 million Americans became newly insured via the exchanges, which doesn’t seem possibly, since there were only about 7.5 million enrollees, and indications are that many enrollees were previously insured. Maybe not most, but more than 20 percent of them. The problem with Gallup’s survey isn’t that it isn’t huge — it’s big enough to have a margin of error of just 1 percentage point — but that we’re looking at a very small subset of it. The margin of error of 1 percentage point could mean that we can only be 95 percent confident that somewhere between 3 and 5 percent of Americans gained coverage, and that as few as 3 million Americans became newly insured through the exchanges. That would be more in line with what other sources have reported, though still pretty high.
The breakdown of newly insured Gallup found tilts low-income; presumably many of the people who got insurance without the exchanges are getting it through Medicaid. They also look marginally sicker than average:
Though an Obamacare death spiral almost surely isn’t going to happen, enrollees don’t need to be much sicker to force premiums up in the future — though that depends on whether insurers expected their enrollees to be sicker than average in the first place.