A new survey from the Commonwealth Fund looks at the relationship of the uninsured rate to the underinsured rate. The survey reports that while the ACA has effectively brought the uninsured rate down, that there are a larger number of individuals who are underinsured. Whether or not someone is considered underinsured is based on the amount of their out-of-pocket expenses in comparison to their income. Prior to the ACA being implemented in 2012, the combined rate of uninsured and underinsured was 35% and those same rates remained at 35% for 2018. However, this was due to the fact that while the uninsured rate was coming down (19% in 2012 to 12% in 2018), the underinsured rate was going up (16% in 2012 to 23% in 2018). However, this growth in the underinsured rate is due largely to changes in employer-based coverage as the underinsured rate in individual coverage was 45% in 2012 and 42% in 2018, while the underinsured rate in employer-based coverage increased from 20% in 2012 to 28% in 2018.