Respondents who reported some other reason cited lack of knowledge about their coverage options, among other reasons. Commonwealth Fund, What Is Your State Doing to Affect Access to Adequate Health Insurance?, interactive map, updated Aug. 22, 2019. Adults who are uninsured are over three times more likely than insured adults to say they have not had a visit about their own health to a doctor or other health professionals office or clinic in the past 12 months.1 They are also less likely to receive recommended screening tests such as blood pressure checks, cholesterol checks, blood sugar screening, pap smear or mammogram (among women), and colon cancer screening.2 Part of the reason for poor access among the uninsured is that half do not have a regular place to go when they are sick or need medical advice, while the majority of insured people do have a regular source of care (Figure 8).3, Figure 8: Barriers to Health Care Among Nonelderly Adults by Insurance Status, 2017, Uninsured people are more likely than those with insurance to report problems getting needed medical care. What are the financial implications of lacking insurance? The Commonwealth Funds Affordable Care Act (ACA) Tracking Survey looked at the reasons why so many Americans still lack health insurance. The Affordable Care Act in Depth | RAND In 2021, 27.5 million nonelderly individuals were uninsured, a drop of nearly 1.5 million from 2019. Two-thirds (67%) of uninsured adults had not gone to the marketplace to examine their coverage options. When asked why, more than one-third (36%) reported it was because they did not think they could afford it, 15 percent said they did not think they needed it, 8 percent said they did not think they would be eligible for insurance, and 7 percent said they were not aware of the marketplace.6. Why Do Millions of U.S. ) or https:// means youve safely connected to the .gov website. How Much Is the National Debt? Why does Arizona still have so many without health insurance? 6 min read Nov. 25According to initial findings from an ongoing study by. The uninsured rate among children under the age of 19 decreased 0.6 percentage points to 5.0 percent between 2020 and 2021, driven in part by an increase in public coverage. Health insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy they are. One of the law's most controversial provisions, this mandate . Why Are Americans Paying More for Healthcare? - The Peter G. Peterson The continued availability of the enhanced Marketplace subsidies will make that coverage more affordable for people who are disenrolled from Medicaid and may increase the share of people who successfully transition from Medicaid to Marketplace coverage. Fourteen percent said they did not reenroll in time and 10 percent had moved.8 After losing Medicaid, about half of these adults remained uninsured, nearly one-third reenrolled in Medicaid, 14 percent enrolled in employer coverage, 3 percent gained individual market coverage, and 3 percent gained Medicare (data not shown). All Rights Reserved. Many uninsured people do not obtain the treatments their health care providers recommend for them because of the cost of care. Read the report to see how your state ranks. Radley, Collins, and Hayes, 2019 Scorecard, 2019. In 2018 there were 18.2 million fewer uninsured people in the U.S. than when the ACA became law.1 In addition, fewer people are forgoing health care because of cost or reporting high out-of-pocket costs relative to their income.2. There are many possible reasons for that increase in healthcare prices: The introduction of new, innovative healthcare technology can lead to better, more expensive procedures and products. In the 10 statesthat have not adopted Medicaid Expansion, 1.9 million uninsured people are in the coverage gap. These adults would only be eligible for their states existing Medicaid program, which is usually only available to children and very poor parents, or unsubsidized plans in the marketplaces. Still, any large increase in the number of people who are uninsured could undermine improvements in access to care and financial stability that come with having health coverage and could worsen disparities in health outcomes. Are You Legally Required to Have Health Insurance | eHealth People who enrolled were much more likely to have received assistancethrough a telephone hotline, insurance broker, or health care navigatorthan those who did not enroll. Social Securitys Funding Gap is 1.3% of GDPHeres How We Can Close It, Poll: Strong Bipartisan Majority of Voters Call for Fiscal Commission. 3. In 2018 there were 18.2 million fewer uninsured people in the U.S. than when the ACA became law. 18. In 2018, 62 percent of adults with individual market plans and 84 percent with Medicaid rated their health coverage as good, very good, or excellent. Despite affordability concerns and changes made by Congress and the Trump administration, a majority of adults with individual coverage continue to give their health insurance high marks. Coverage estimates are not mutually exclusive because people can be covered by more than one type of health insurance during the year, so the sum of those numbers are greater than the U.S. population. In. Browse our collection of stories and more. In 2017, 19% of uninsured adults said they delayed or did not get a needed prescription drug due to cost, compared to 14% with public coverage and 6% with private coverage.5 And while insured and uninsured people who are injured or newly diagnosed with a chronic condition receive similar plans for follow-up care from their doctors, people without health coverage are less likely than those with coverage to obtain all the recommended services.6,7, Because uninsured people are less likely than those with insurance to have regular outpatient care, they are more likely to have negative health consequences. Print Data are for the U.S. Health Insurance Coverage Eight Years After the ACA How Many Uninsured People Are in the ACA Coverage Gap? This survey is the eighth in a series of Commonwealth Fund surveys to measure access to affordable health care over time. To accomplish this, the law expanded insurance coverage in three ways: . The Uninsured and the ACA: A Primer Key Facts about Health. However, the uninsured rate for the group of expansion states was nearly half that of non-expansion states (7.7% vs. 15.1%). More than one-third of the uninsured were Latino even though Latinos make up 18 percent of the working-age adult population (Table 1). While the improvements in coverage were widespread, they were particularly large for Hispanic people, those in low-income families, and among people in working families, including those with only part-time workers in the family. Since then, additional states have adopted a policy to expand eligibility, bringing the total to 39 states and jurisdictions. The Supplemental Poverty Measure (SPM) allows the Census Bureau to see how different government programs like SNAP impact the number Survey of Income and Program Participation (SIPP), Selected Characteristics of the Uninsured in the United States. The number of uninsured individuals remains well below levels prior to enactment of the ACA. Even under the ACA, many uninsured people cite the high cost of insurance as the main reason they lack coverage. The survey consisted of telephone interviews in English and Spanish and was conducted among a random, nationally representative sample of 4,225 adults ages 19 to 64 living in the continental United States. Coverage gains were greater for nonelderly adults compared to children. Changes in the number of uninsured individuals varied across states in 2021. Additionally, in non-expansion states, millions of poor uninsured adults fall into a . By continuing on our website, you agree to our use of the cookie for statistical and personalization purpose. They tended to be 19 to 64 years old, male, have less than a high school education and/or have lower incomes. More than half (57%) of adults who were either uninsured at the time of the survey or had a gap in insurance coverage in the past 12 months and who were previously covered by Medicaid reported they lost their Medicaid coverage because they were no longer eligible. Explore census data with visualizations and view tutorials. Why are people uninsured? Uninsured rates for children under the age of 19 in poverty rose 1.6 percentage points to 9.3 percent. Uninsured people are far more likely than those with insurance to postpone health care or forgo it altogether. Who Are the Remaining Uninsured, and Why Do They Lack Coverage? A. Why People Are Uninsured - 565 Words | 123 Help Me How Can We Reduce Unnecessary Healthcare Spending in the US? Total healthcare spending in the United States is projected to account for nearly one-fifth of the economy by 2025. The Commonwealth Fund Biennial Health Insurance Survey, 2018, was conducted by SSRS from June 27 to November 11, 2018. About two-thirds of uninsured people were eligible for some form of subsidized coverage, although the generosity of available subsidies varied on the basis of peoples family income, access to employment-based coverage, and other factors. Munira Z. Gunja, Senior Researcher, International Program in Health Policy and Practice Innovations, The Commonwealth Fund, Munira Z. Gunja and Sara R. Collins, Who Are the Remaining Uninsured, and Why Do They Lack Coverage? FDA approves first over-the-counter birth control pill - POLITICO The unwinding data are pulled from state websites and from the Centers for Medicare & Medicaid Services (CMS). From 2018 to 2021, enrollment in employment-based plans declined by about 65,000 people. Thirty states and the District of Columbia have reported disenrolling more than 2,181,000 Medicaid enrollees as of July 14. Over half of all people without health insurance coverage were male (54.6 percent), even though the U.S. population has more women than men. About 8% of people ages five and older . Research Matters Blog. At the same time, likely due to pandemic-related disruptions to employment, the share of people with employer-sponsored insurance dropped from 58.1% in 2019 to 57.0% in 2021 (Figure 2). Private health insurance covered 67% of Americans. By contrast, only a small fraction of the uninsured just 1.4 percent were age 65 and over. Four percent of adults ages 19 to 64 who were uninsured at the time of the survey or uninsured in the past 12 months and were previously covered by a plan bought on their own or through the marketplace reported they lost or dropped their marketplace coverage because they couldnt get the health care they needed, 2% reported it was because they didnt think they needed it, and 1% reported it was because they moved. Ten of the fifteen states with the highest uninsured rates in 2021 were non-expansion states as of that year (Figure 6 and Appendix Table A). more likely to be uninsured than those with higher incomes, around 14 percent of the uninsured had incomes of 400 percent FPL or higher.12 Over half (52 percent) of the uninsured population lived in families of two or more people, and a majority (82 percent) of the remaining uninsured live in families with at least one full time worker. In 2021, the drop in the number of people without health insurance was driven primarily by an increase in Medicaid coverage as well as a smaller increase in non-group coverage, which includes coverage in the Marketplaces. The disenrollment rate ranges from 76% in Idaho to 10% in Michigan. In 2019, there were 28.9 million who were uninsured for a . How Does the US Healthcare System Compare to Other Countries? Changes in coverage between 2018 and 2021 may be related to changes in labor force composition throughout the pandemic and recent economic recovery, in addition to policies addressing the COVID-19 pandemic. In fact, most uninsured people (84.6 percent) were 19- to 64-year-olds. Of the total nonelderly uninsured population in 2021, just over seven in ten (70.2%) had at least one full-time worker in their family and an additional 11.6% had a part-time worker in their family. 20. Who Went Without Health Insurance in 2019, and Why? The Census report also provides significant insights about the state of healthcare access in America during the midst of the pandemic. Kendal Orgera , and Though the number has improved significantly over the past decade, nearly 30 million Americans remain uninsured. Many people who were uninsured were eligible for financial assistance either through Medicaid or through subsidized Marketplace coverage. Using data from the American Community Survey (ACS), this analysis compares health coverage data for 2021 to data for 2019; because of disruptions in data collection during the pandemic, the Census Bureau did not release 1-year ACS estimates in 2020. Across age groups, young adults ages 19 to 34 made up the largest share of the uninsured. Why do people go uninsured? The uninsured population was also disproportionately more likely to live in poverty. Matthew Buettgens, Lisa Dubay, and Genevieve M. Kenney, Marketplace Subsidies: Changing The Family Glitch Reduces Family Health Spending But Increases Government Costs, Health Affairs 35, no. Uninsured rates also decreased for Asian people (from 7.2% to 6.4%), White people (from 7.8% to 7.2%) and Black people (from 11.4% to 10.9%). This still holds true in the data from the pandemic, as those are also the groups that have been the most heavily affected by COVID-19 in regards to employment and health. Commonwealth Fund, What Is Your State Doing?, 2019. The National Debt Could Nearly Double in Size Over the Next 30 Years. Free clinic targets underserved, uninsured population in Hampton Roads Five Charts about the Future of Social Security and Medicare, Why the American Healthcare System Underperforms, CBO: Percent of Uninsured Rose Last Year for the First Time Since 2010, Trustees: Funding Challenges Threaten Medicares Future, U.S. Defense Spending Compared to Other Countries, Income and Wealth in the United States: An Overview of Recent Data. Despite affordability concerns and changes made by Congress and the Trump administration, 62 percent of adults with individual coverage and 84 percent with Medicaid rated their coverage as good, very good, or excellent.. Nearly half of uninsured adults may have been eligible for subsidized insurance through the marketplace or their states expanded Medicaid program. 9. 8. Most people who were uninsured at a particular point in recent years went without coverage for at least one year. The independent source for health policy research, polling, and news. Access demographic, economic and population data from the U.S. Census Bureau. In this report, the Congressional Budget Office describes that uninsured population. Some uninsured who are eligible for help may not be aware of coverage options or may face barriers to enrollment, and even with enhanced subsidies, Marketplace coverage may be unaffordable for some uninsured individuals. Before these reforms, in 2010, 60 percent of adults who had individual coverage or had tried to buy it in the past three years said it was very difficult or impossible to find affordable coverage. The adult uninsured rate was 12.5 percent. Stand on Insurance Coverage? To find out more about the uninsured population, such as employment characteristics, disability status, nativity and residence, or about the uninsured population in smaller geographic areas (states, counties and zip codes), see Table S2702"Selected Characteristics of the Uninsured in the United States. Prior to the enactment of the ACA in 2010, people of color were at much higher risk of being uninsured compared to White people, with . Most of the uninsured (77.1%) were U.S. citizens while 22.9% were non-citizens in 2021 and nearly three-quarters live in the South and West. 7. The authors thank Robyn Rapoport, Rob Manley, and Erin Czyzewicz of SSRS, and David Blumenthal, Elizabeth Fowler, Chris Hollander, Deborah Lorber, Paul Frame, Jen Wilson, Gabriella Aboulafia, Corinne Lewis, and Roosa Tikkanen of the Commonwealth Fund. Is our healthcare system broken? - Harvard Health 25. Yet about 24 million people still lack coverage. , particularly in states that expanded Medicaid. Among less than full-time, year-round workers, the . . 12. Health Reform, Affordable Care Act, Coverage and Access, 2023 The Commonwealth Fund. Health Insurance: How Uninsured Affect You These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.28,29. Uninsured people have less financial protection and access to health care than people with insurance, although the degree of those differences varies for indi-viduals in different circumstances. How Many Americans Are Uninsured? - MoneyGeek Research has shown that adults who experience gaps in their health insurance coverage are less likely to have a regular source of care or to be up to date with blood pressure or cholesterol checks than those with continuous coverage.20 Research also indicates that children who are uninsured for part of the year have more access problems than those with full-year coverage.21,22 Similarly, adults who lack insurance for an entire year have poorer access to care than those who have coverage for at least part of the year, suggesting that even a short period of coverage can improve access to care.23, Research demonstrates that gaining health insurance improves access to health care considerably and diminishes the adverse effects of having been uninsured. The rate of uninsured US citizens increased from 25.6 million in 2016, to 27.5 million in 2017. After several years of coverage losses prior to the start of the pandemic, the uninsured rate dropped from 2019 to 2021, driven largely by increases in Medicaid coverage as well as increases in non-group Marketplace coverage during the pandemic. Most of the nonelderly in the U.S. obtain health insurance through an employer, but not all workers are offered employer-sponsored coverage or, if offered, can afford their share of the premiums. The increased reliance on public health insurance stemmed from the fact many people became eligible for Medicaid and CHIP due to lay-offs and provisions in the Families First Coronavirus Response Act that required states to ensure continuous enrollment. Percent of uninsured adults who reported delaying or not getting care due to health costs, Percent of uninsured adults who worry about medical bills if they get sick or have an accident, Percent of uninsured adults who reported not having a usual place of care (vs. 7% of insured adults).
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