Dive Brief:
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The uninsured rate decreased from 9.1% in 2015 to 8.8% in 2016 (a record low), according to a new U.S. Census report. The 8.8% uninsured figure mirrors a National Center for Health Statistics 2017 National Health Interview Survey released last month.
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The rate of Medicare coverage increased from 16.3% to 16.7% in that period. Medicare was the only health insurance subtype that saw any “statistically significant difference” between 2015 and 2016.
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Children in poverty are more likely to not have health insurance than children not in poverty. While the uninsured rate for children under the age of 19 stayed steady at 5.4%, the rate of children living in poverty without health insurance (7%) outpaced uninsured children not in poverty by two percentage points.
Dive Insight:
The U.S. Census found the overall percentage of insured Americans increased by about 4 percentage points since 2013 and more than 3 percentage points insured by a private health plan, which is mostly due to the Affordable Care Act (ACA) plans and individual mandate that requires most Americans to have health insurance. The percentage of employer-based insurance plans has stayed around the same since 2013 (55.7% of plans).
Public plans, such as Medicare and Medicaid, have added 11 million members since 2013. Medicaid now covers 19.4% of Americans and Medicare covers 16.7%. Having more people covered through Medicaid and through ACA plans means less uncompensated care and bad debt for hospitals.
The U.S. Census found states that expanded Medicaid saw a larger decrease in the uninsured rate than the non-expansion states between 2015 and 2016. The uninsured rate remains higher in 19 non-expansion states. Medicaid expansion states average 6.5% uninsured compared to 11.7% in non-expansion states with Massachusetts (2.5%) and Texas (16.6%) on either extreme.
The Kaiser Family Foundation (KFF) recently released a report that showed uncompensated care, including charity care and bad debt, dropped 17% after costing hospitals $34.9 billion in 2013. Nearly all of the decrease in 2014 came from Medicaid expansion states. “The cost of uncompensated care has declined among hospitals in Medicaid expansion states, while such costs have remained flat among hospitals in states that did not expand Medicaid,” said KFF.
While the percentage of insured Americans continued to fall in 2016, supporters of the Affordable Care Act (ACA) are worried that decisions and inactions by the President Donald Trump's administration may lose those gains in the coming years. Over the past week, ACA plan navigators, who help people connect with ACA plans, said they are ending or cutting back services because the HHS hasn’t given them contracts and the federal government hasn’t allocated funding to pay them for this year’s open enrollment period, which starts on Nov. 1. Plus, the Trump Admission cut the ACA plan open enrollment period in half this year and slashed the advertising budget to promote ACA plans by 90%. All of those moves could lead to fewer Americans enrolled in ACA plans in in 2018.