At a Glance

• The number of uninsured nonelderly adults fell by an estimated 10.6 million between September 2013 and September 2014 as the uninsurance rate fell from 17.7 percent to 12.4 percent—a drop of 30.1 percent. • Most of the gain in coverage was among the low- and middle-income adults targeted by the ACA's Medicaid and Marketplace provisions. • The uninsurance rate dropped 36.3 percent in states that implemented the ACA’s Medicaid expansion, compared with 23.9 percent in nonexpansion states; 54.7 percent of uninsured nonelderly adults lived in nonexpansion states in September 2014. The Urban Institute’s Health Reform Monitoring Survey (HRMS) has been tracking insurance coverage since the first quarter of 2013. Data from the HRMS have provided an early look at changes in the nation’s uninsurance rate following the implementation of the Affordable Care Act’s (ACA) key coverage expansion provisions, including the launch of new health insurance Marketplaces and the state option to expand Medicaid to nearly all adults with family income at or below 138 percent of the federal poverty level (FPL).1 The HRMS provides early feedback on ACA implementation to complement the more robust assessments that will be possible when the federal surveys, which ar