According to Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) study, the first three months of 2015 saw a total of 29 million (9.2.percent) uninsured people of all ages nationwide . This represents 7 million fewer uninsured men and women than 2014’s uninsured rate of 11.5 percent.
The NCHS released these latest estimates in its quarterly January–March 2015 National Health Interview Survey (NHIS). The agency also took into account comparable estimates from the 2010– 2014 NHIS reports. Overall, the number of uninsured Americans continues to decline from 2013. The findings show the levels of uninsured people falling across multiple demographics, including race, financial status and the type of health coverage.
Delving into the government’s findings
Age — The CDC’s findings showed that for the rates of uninsured American adults, there were decreases among children and adults. The period of 1997-2010 showed general increases for the percentage of adults aged 18–64 who were uninsured at the time of interview. However, this same percentage decreased from 2010’s 22.3 percent to 13.0 percent in the first three month of 2015. Specifically, the study revealed that:
- Among children under age 18 years, the percentage with private coverage increased from 2013’s 52.6 percent to 56.3 percent in 2015’s first three months. This reverses a 14-year trend of declining rates of private coverage.
- Among adults age 18-64, the percentage of uninsured decreased from 2014’s 16.3 percent to 13.0 percent in 2015’s first three months. Private coverage also experienced a corresponding increase, from 67.3 to 70.4 percent.
- Among those under age 65, the percentage with private coverage through the Health Insurance Marketplace or state-based exchanges increased, from 2.5 percent (6.7 million) in 2014’s last 3 months to 3.6 percent (9.7 million) in 2015’s first three months.
Among those aged 18-64, there were also corresponding increases in public and private coverage. 2015’s first three months found that among children aged 0–17 years, 4.6 percent were uninsured, 40.4 percent had public coverage and 56.3 percent had private coverage. When it came to lacking health insurance, the first three months of 2015 found that:
- 4 percent of adults aged 18-24 were uninsured
- 3 percent of adults aged 25–34 were uninsured
- 14 .0 percent of adults aged 35-44 were uninsured
- 0 percent of adults aged 45–64 were uninsured
For children 0-17 years, the uninsured rates decreased, from 1997’s 13.9 percent to 4.6 percent in 2015’s first three months. From 1997-2010, the percentage of children with private coverage generally decreased, while the percentage with public coverage generally increased. More recently, the percentage of children with public coverage has leveled off, while the percentage with private coverage has increased, from 2013’s 52.6 percent to 56.3 percent in 2015’s first three months.
Among all age groups, with the exception of adults aged 18– 24, uninsured rates at the time of the interview remained relatively stable from 2010-2013. Among adults aged 18–24, the uninsured rates decreased, from 2010’s 31.5 percent to 2011’s 25.9 percent; the rates then remained stable through 2013. However, from 2013 through 2015’s first three months, all age groups’ uninsured percentages decreased significantly.
Poverty – In the CDC’s study, income levels had an impact on rates of coverage among adults aged 18-64. For 2015’s first three months, 28.0 percent of poor adults were uninsured 23.8 percent of near-poor were uninsured and 7.5 percent of those who were not poor were uninsured.
The period from 2010 through 2015’s first three months showed a decrease in the percentage of uninsured adults among all poverty groups. For children aged 0-17 during 2015’s first three months, 4.6 percent of the poor were uninsured, 7.9 percent of near-poor were uninsured and 3.3 percent of those not poor were uninsured.
Race and ethnicity – In 2015’s first three months, the rates of uninsured adults decreased among different races and ethnicities. Hispanic adults showed the largest decrease in uninsured rates; these fell from 2013’s 40.6 percent to 28.3 percent in 2015’s first three months. At the time of interview, the first three months of 2015 showed that:
- 3 percent of Hispanic adults aged 18–64 lacked health insurance coverage
- 6 percent of non-Hispanic black adults aged 18–64 lacked health insurance coverage
- 7 percent of non-Hispanic white adults aged 18–64 lacked health insurance coverage
- 2 percent of non-Hispanic Asian adults aged 18–64 lacked health insurance coverage
Periods of non-coverage – The researchers determined that the percentage of uninsured adults aged 18–64 decreased overall. Specifically, the percentage dropped from 2013’s 20.4 percent (39.6 million) to 13.0 percent (25.5 million) in the first three months of 2015.
Further, the percentage of adults who were uninsured for at least part of the past year decreased from 2013’s 24.4 percent (47.4 million) to 18.9 percent (37.0 million) in 2015’s first three months. And, the percentage of adults who were uninsured for more than a year decreased from 2013’s 15.7 percent (30.5 million) to 9.5 percent (18.6 million) in 2015’s first three months.
Private exchange coverage – For 2015’s first three months, 66.5 percent (179.1 million) of Americans under age 65 were covered by private health insurance plans. This includes the 3.6 percent (9.7 million) covered by private plans obtained through the Marketplace or state-based exchanges.
Among adults under age 65, there was a significant increase in the percentage of plans obtained through the Marketplace or state-based exchanges. The last quarter of 2014 (Oct.-Dec.) saw 2.5 percent (6.7 million), compared to 3.6 percent (9.7 million) in 2015’s first quarter (Jan.-March). Among those aged 18–64, 70.4 percent (137.7 million) were covered by private health insurance plans from Jan.-March 2015. This includes 4.4 percent (8.6 million) covered by private health insurance plans obtained through the Marketplace or state-based exchanges.
Health insurance coverage by state Medicaid expansion status – With 2010’s establishment of the Affordable Care Act (ACA), states gained the option to expand coverage for Medicaid. This is the federal healthcare program for families and individuals with low income and limited resources. During 2015’s first three months, adults aged 18–64 residing in Medicaid expansion states were less likely to be uninsured than those in non-expansion states. The uninsured percentage in expansion states decreased from 2013’s 18.4 percent to 10.6 percent in 2015’s first 3 months. In non-expansion states, this percentage decreased from 2013’s 22.7 percent in 2013 to 16.8 percent in 2015’s first three months.
Health insurance coverage by state Marketplace type – The ACA’s provisions give states the option to provide their preferred method for health insurance coverage:
- Establishing and operating their own Health Insurance Marketplace
- Relying on a Federally Facilitated Marketplace (FFM) operated solely by the federal government
- Having a hybrid partnership Marketplace operated by the federal government; however, the state runs certain functions and makes key decisions
For 2015’s first three months, the study showed that adults aged 18–64 in states with FFMs were more likely to be uninsured than those in states with a state-based Marketplace or a hybrid partnership Marketplace. During this same period, no difference was seen in the percentage of adults aged 18–64 with private coverage by Marketplace type. However, for adults 18-64, decreases in uninsured rates between 2013 and 2015’s first three months were seen in states with state-based Marketplaces, a partnership Marketplace and an FFM.
Estimates of enrollment in HDHP’s and CDHP’s – During 2015’s first three months, 36.0 percent of adults under age 65 with private health insurance were enrolled in a high-deductible health plan (HDHP). This includes 13.3 percent enrolled in a consumer-directed health plan (CDHP) with a health savings account (HSA). It also includes 22.7 percent enrolled in an HDHP without an HSA.
HDHPs are private health plans with higher deductibles than traditional plans; they’re adjusted annually for inflation. For 2015, the annual deductible for individuals was $1,300 and $2,600 for families. HDHPs can be combined with a health savings account or a health reimbursement arrangement. They enable you to pay for qualified out-of-pocket medical expenses on a pre-tax basis. HDHP enrollment among those with private insurance has generally increased since 2010.
CDHPs are HDHPs with a special account to pay for medical expenses. They allow consumers to control and manage their own healthcare costs, by paying routine health care expenses directly. CDHPs allow you to shop around and compare prices and providers. As CDHPs allow doctors to repackage and reprice their services, they compete for patients based on price and quality.
It’s important to note that consumers can switch over to a Marketplace plan during the Open Enrollment Period. It restarts on November 1, 2015, and all Americans must enroll in health insurance or face a tax penalty of $695 per adult for 2016.