Practice Economics

Uninsured number holds steady during ACA implementation lull


 

About 48 million Americans lacked health insurance in 2012, a figure not significantly changed from 2011, according to data released by the U.S. Census Bureau on Sept. 17.

But the percentage of Americans who had health coverage rose slightly in 2012, compared with 2011. The most recent figures from the Census Bureau show that 84.6% of Americans had health insurance in 2012, compared with 84.3% in the previous year. Gains in coverage came largely from government programs such as Medicare, Medicaid, and military health care programs.

Private insurance coverage held steady between 2011 and 2012, with 64% of Americans getting their coverage from those plans. Most private coverage was employer-sponsored.

Dr. David Johnson

The percentage of Americans whose health coverage came from government-sponsored programs increased for the sixth consecutive year, growing to 33%. Though Medicaid coverage stayed about the same at about 16%, Medicare coverage rose from 15.2% to 15.7% between 2011 and 2012. That uptick is likely due to the first wave of baby boomers entering the Medicare program, said David S. Johnson, Ph.D., chief of the social, economic, and housing statistics division of the U.S. Census Bureau.

The rate of uninsured among children under age 18 fell from 9.4% (7.0 million) to 8.9% (6.6 million) between 2011 and 2012.

However, the uninsured rate was statistically unchanged in all other age groups, including young adults aged 19-25 years. Since 2009, the uninsured rate for young adults had dropped 4.2%, putting it on par with adults aged 26-34 years. The recent decline has been attributed to the Affordable Care Act provision that allows young adults to stay on their parents’ health insurance as dependents up to age 26. But now that the provision has been in effect for a few years, the bulk of the declines have been realized, Dr. Johnson said.

The ACA has also required states to maintain their eligibility levels for Medicaid and the Children’s Health Insurance Program (CHIP), said Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities. "Medicaid and CHIP have either increased or stayed steady and, particularly in the case of kids, that has more than offset declines in private coverage," he said.

But the most dramatic impacts of the ACA won’t be seen until 2014, when the health insurance exchanges open and some states expand their Medicaid eligibility, Mr. Park said. He cited Congressional Budget Office estimates that about 13 million individuals who otherwise would be uninsured would gain coverage in 2014, with the number rising to about 25 million by 2016. But due to the 1-year lag in census data, data on the extent of the insurance uptake won’t be available until 2015, he said.

The current census findings are based on data from the Current Population Survey Annual Social and Economic Supplement.

mschneider@frontlinemedcom.com

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