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Census Bureau report finds decrease in number of uninsured Americans

Posted on September 13, 2012 | No Comments

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Key Developments

The Census Bureau report published yesterday found that the number of uninsured Americans fell to 48.6 million in 2011, or 15.7 percent of the population. This is the first drop in uninsured Americans since 2007. In 2010, 49.9 million people, or 16.3 percent of the population, were uninsured. Census Bureau officials attribute the drop in large part to provisions under the Affordable Care Act (ACA). The drop in the number of uninsured Americans was fueled by a significant drop in uninsured young Americans aged 19 to 25, from 29.8 percent in 2010 to 27.7 percent in 2011, the Census Bureau said. The rate also decreased among seniors. The Bureau also found that the percentage of Americans covered by private insurance remained flat at 63.9 percent. The percentage of Americans covered by government programs increased for the fifth consecutive year to 32.2 percent in 2011.

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The Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics released the results of its first quarter health insurance survey. The results show that the percentage of uninsured adults dropped to 18.4 percent from 20.4 percent in 2013. However, this modest reduction does not capture the influx of last minute sign-ups in March and is lower than other estimates that used data from later in the year. A new Census report also examined uninsurance rates finding that forty-two million people in the U.S. lacked any health insurance for the whole of 2013- 13.4 percent of the population. The report breaks down the uninsured rate by race and estimates the proportion of the population insured through private, employer-sponsored, and public insurance. However, this report does not include data from the major expansion of coverage from the Affordable Care Act (ACA) starting in 2014.
Enrolling the uninsured population into the health insurance marketplaces is a key component of the Affordable Care Act (ACA). To aid in this effort, the US Centers for Medicare and Medicaid Services (CMS) recently released a brief describing various characteristics of the uninsured population in America. The uninsured population can be divided into three main segments:
  • Healthy and Young
  • Sick, Active and Worried
  • Passive and Unengaged
Designed as a guidance tool for those poised to enroll individuals into the health insurance marketplace (insurers, consumer advocates and state officials), this brief outlines potential barriers and concerns to enrollment, as well as key messages to share with each segment about the importance of being insured.
Two studies by the Urban Institute show that the provisions of the Affordable Care Act (ACA) have in many cases helped to insure more parents, but have not been as successful at increasing coverage for their children. The studies found that nationally, between September 2013 and June 2014, the estimated uninsured rate for parents fell 2.4 percentage points from 16.7 percent to 14.3 percent. However, for the same time period, no statistically significant change was found in the estimated uninsured rate for children under age 17. Additionally, findings suggest that the majority of uninsured children are eligible for Medicaid or the Children's Health Insurance Program (CHIP)  but are not yet enrolled. The implications of these studies could be important as Congress considers whether to reauthorize funding for CHIP beyond 2016.
A new study by the Urban Institute funded by the Robert Wood Johnson Foundation finds that two-thirds of the nation’s remaining uninsured adults have incomes at or below 138 percent of the federal poverty level (FPL). While this is the target population of the Affordable Care Act’s (ACA) Medicaid expansion, 40 percent of the uninsured live in states that chose not to expand Medicaid. The study found that affordability was the main reason people did not get health insurance, yet many uninsured individuals had limited awareness of potential financial help available to them.
A new study published in the New England Journal of Medicine found that an estimated 10.3 million adults gained insurance coverage under the Affordable Care Act (ACA).  The study, performed by Harvard researchers, reported a 5.2% decline in the uninsured rate during the first open enrollment period.  Data analyzed for this project included Gallup polls and ACA enrollment statistics from the US Department of Health and Human Services (HHS).
A new study published in Health Affairs found that open enrollment for the Affordable Care Act (ACA) should coincide with the tax filing season. The researchers argued that consumers are more likely to make better decisions with their health coverage when taxes are on their minds, not the stresses associated with holiday spending. Currently, ACA open enrollment for 2015 is scheduled for November 15, 2014 to February 15, 2015. Another study from the Urban Institute indicates that Medicaid expansion was associated with a reduction in the number of uninsured individuals as of March 2014. The study, which relied upon data from Urban’s Health Reform Monitoring Survey, found that states expanding Medicaid saw a drop in the uninsurance rate by 4%, whereas states that did not expand Medicaid saw a 1.4% reduction. Unlike the ACA open enrollment period, individuals eligible for Medicaid can enroll in the program at any point in a year.
A new interactive feature released by the Kaiser Family Foundation indicates how the Affordable Care Act (ACA) may impact Medicaid enrollment and the uninsured demographic at the local community level. The interactive tool is accompanied by a report, as well as other interactive features, that describes how the Medicaid population will change after the ACA is implemented and how the uninsured population will decrease both in and amongst states post-ACA.
A recent post from Health Affairs estimates that 30 million Americans will still not have insurance coverage by 2016, well beyond the implementation of the Affordable Care Act's (ACA) key provisions. The Uninsured After Implementation Of The Affordable Care Act: A Demographic And Geographic Analysis characterized states based upon their proclivity for expanding Medicaid: completely undeclared, leaning toward expansion, or leaning away from expansion. Using data from the Census Bureau's 2012 Current Population Survey, the researchers found that 29.8 million people would remain uninsured if all undeclared states opt-in to expansion, while 31 million would remain uninsured if all undeclared states chose to opt-out of expansion. Additionally, researchers found that 80% of those remaining uninsured would be US citizens in either scenario.
According to a new survey released by the Commonwealth Fund, 84 million Americans were either uninsured or under-insured in 2012. In addition, 75 million Americans in 2012 were either actively paying or having difficulty paying their medical bills, indicating that medical debt is still a prominent issue. Findings were not bleak for all demographics, however, as the 2012 Biennial Health Insurance Survey also found that the proportion of uninsured individuals ages 19-25 decreased from 48% to 41% in 2012. This phenomenon is most attributable to the Affordable Care Act's (ACA) provision that allows children to remain on their parents' health insurance until age 26.