Workers Gaining Health Insurance Coverage Under the ACA

Man working in a recycling facility.

14.7 million working Americans and family members gained health coverage under the Affordable Care Act (ACA).



The Issue

Roughly 9.5 million working Americans under age 65, along with 5.2 million of their family members, gained health insurance coverage from 2010 to 2015 under the ACA. They represent 77 percent of all of those who gained coverage in the first six years of the ACA.

Key Findings

  • Occupations in which less than 70 percent of workers had health insurance in 2010—such as farming, food preparation and construction—saw a 13.4 percentage point increase in rates of insured workers by 2015.

  • Occupations where 70-80 percent of workers had coverage in 2010—such as transportation and health care support—saw an increase of 9.6 percentage points.

  • Workers making less than $15 per hour in 2010 saw their rate of insurance coverage increase by 14.3 percentage points by 2015.

  • Of the 9.5 million workers who gained coverage, 6.0 million (63%) lived in states that expanded Medicaid eligibility under the ACA.



The ACA resulted in a large increase in the number of American workers who have health coverage for themselves and their families. Workers in industries that typically had the weakest coverage made the largest gains, and workers making salaries typically associated with lower coverage rates saw larger increases in coverage, showing that coverage gains under the ACA were well-targeted.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.