Health Affairs reports that U.S. Census Bureau figures indicate that after full implementation of the ACA in 2014 and the expansion of insurance coverage that followed, there was a sharp drop in the number of uninsured Americans. That level has now stabilized, with the percentage of uninsured for the entire year dropping from 9.1 percent (29 million) in 2015 to 8.8 percent (28.1 million) in 2016.
Coverage changed only marginally for most forms of insurance, with the only statistically significant gain in coverage (0.4 percent) occurring in the Medicare population.
Modern Healthcare reports that job-based insurance is still the most common source of coverage, with 55.7 percent of people finding insurance that way. Medicaid accounts for 19.4 percent, while Medicare takes care of 16.7 percent. When it comes to buying insurance directly from a health plan or through an exchange, 16.2 percent receive coverage that way; 4.6 percent have military-based coverage.
Thirty states have opted to expand Medicaid as of January 1 of this year, and in those states, the uninsured rate was lower (6.5 percent) than in states that chose not to expand (11.7 percent). Data indicate that Medicaid expansion seems to be the main factor in the drop of uninsured since 2013; in addition, the variance in uninsured rates ranges from 2.5 percent in Massachusetts to 16.6 percent in Texas.
Most age groups under 65 experienced a drop in those lacking coverage, with working-age adults experiencing generally larger decreases. However, working-age adults are less likely to be covered than children, or than adults over age 65. Children’s uninsured rate is fairly constant at 5.4 percent. And Hispanics are still the highest uninsured population, at 16 percent, with non-Hispanic whites the lowest, at 6.3 percent.
Married people are more likely to have coverage, at 91.2 percent, than those who were widowed or divorced (86.1 percent), never married (84 percent), or separated (80.8 percent). Those who work full-time all year are also more likely to have coverage, at 90.2 percent, than part-timers or part-year workers (85.2 percent) or nonworkers (85 percent).
Those in higher income brackets are also more likely to be covered, with those having household incomes of $125,000 or more coming in at a rate of 95.8 percent, compared with those making less than $25,000 (just 86.3 percent). Yet 68 percent of people with incomes below $25,000 had government coverage, compared with just 18.8 percent of that higher-income group.
Between 2015 and 2016, the coverage rate rose by 1.1 percent for those making less than 100 percent of the federal poverty level, but fell by 1 percentage point for those with incomes between 200 and 299 percent of the poverty level.