The USA’s effort to reduce the uninsurance rate through the Affordable Care Act: Is it working?

  • Angelo Ercia (Speaker)

Activity: Talk or presentationOral presentationResearch


The health care reform called The Patient Protection & Affordable Care Act (ACA) of the USA was implemented in2010. One of the major goals of the reform was to decrease the uninsurance rate by expanding public and private health insurance coverage. This study reviews recent published peer-reviewed and grey literature to determine the extent of the ACA’s ability to reduce uninsurance rate after 2010 among low-income non-elderly adults and its outcome. Method: CINAHL, Medline, GreyLit, and the US National Medical Library were systematically investigated to identify studies published between 2010–2015 that reported the changes of the uninsurance rate in the USA after 2010. Publications were included if it investigated the changes in health insurance coverage among low-income non-elderly adults (18-64 years). Outcomes as a result of expanding coverage were also included in the review. Results: 19 studies were included in the review. According to five national surveys that used representative samples, the uninsurance rate among non-elderly adults slightly decreased between 2010–2013. The age group 19–25 years had the highest decrease of being uninsured between 2010–2013. States that expanded public insurance (called Medicaid) had a higher reduction of their uninsurance rate compared to states that didnot expand it. While more people are getting coverage, they are also confronting issues on being underinsured or falling in the coverage gap. Healthcare providers are anticipating the issue of meeting the increase of demand for care. Conclusion: The ACA has begun to reduce the uninsurance rate in the USA since 2010, and the young adult population had the highest decrease of being uninsured so far. States that expanded public insurance also experienced higher decrease of their uninsurance rate. With the increase in demand for care, accessing care may become a problem due to limited providers. Key messages: The Affordable Care Act is reducing the uninsurance rate in the USA. Outcomes of increasing people gaining coverage are: underinsurance, coverage gap, not meeting increase demand for care, need of more provider.
Period1 Oct 2015
Event titleEuropean Public Health Conference
Event typeConference
LocationMilan, ItalyShow on map