Some notes on the RAND survey

RAND has released its latest survey results on the health insurance status of American adults aged 18-64, spotlighting changes in health insurance enrollment since 2013. The results are based on survey responses from 2,425 people -- and since RAND surveys its panel monthly, it is able to track changes in health insurance status, pegging sometimes quite wide margins of error for each finding. The top line is that an estimated 9.3 million more people had health care coverage in March 2014 than in September 2013 (albeit plus or minus 3.5 million). That is, as Adrianna McIntyre frames it, "the uninsured rate among 18-64 year old adults in the United States fell by 23 percent—from 20.5 percent to 15.8 percent."

Adrianna also spotlights the report's biggest surprise: that the bulk of the increase comes from an estimated 8.2 million people gaining employer-sponsored insurance (ESI). RAND speculates that "some" of these people "may have taken up an employer plan as a result of the individual mandate; others may have newly found a job."  RAND found that only about 1.4 million people gained coverage from the new exchanges, as only about a third of the 3.9 million they found gaining coverage through the exchanges were previously uninsured.

A few thoughts and questions in response to the RAND findings are outlined below. My own confirmation bias may be at work, but I suspect that more than one third of ACA private plan signups were previously uninsured, for reasons outlined mainly in point #5.