3 reasons it’s significant that the percentage of uninsured Americans hit an all-time low

Source: National Center for Health Statistics, National Health Interview Survey, 2021–2022. Cohen RA and Cha AE. Health insurance coverage: Early release of quarterly estimates from the National Health Interview Survey, January 2021–March 2022. National Center for Health Statistics. July 2022.

The percentage of Americans who lack health insurance hit an all-time low of 8% in the first quarter of this year, reflecting an increase of 5.2 million people who gained coverage since 2020, according to a report by the federal Department of Health and Human Services (HHS) released on Tuesday. 

Using data from the National Health Interview Survey and the American Community Survey, the report from the HHS Assistant Secretary for Planning and Education (ASPE) shows the effect of better subsidies for health insurance that consumers buy on the Affordable Care Act’s marketplaces, increased federal efforts to encourage the uninsured to enroll, the continuous enrollment provisions in the federal-and-state Medicaid program and recent decisions in several states to increase enrollment in Medicaid, HHS said in a press release

Since 2019, seven states have expanded enrollment in the federal-and-state funded Medicaid program, according to Louise Norris at HealthInsurance.org. Those states are: Virginia and Maine in 2019; Utah, Idaho, and Nebraska in 2020; and Oklahoma and Missouri last year, she wrote.

The HHS announcement is significant for three reasons. First, the all-time low 8% rate means that about 26.4 million people lack health insurance, down from 48 million in 2010, according to an ASPE report last year. Second, the report includes a table showing changes in the uninsured rates in each state for low-income adults ages 18 to 64 from 2018 to 2020. In 18 states (15 of which expanded Medicaid), the uninsured rates for this population dropped in those years.

Third, the report is crucial because Congress is considering a bill that would extend the subsidies for health insurance consumers buy on the ACA’s marketplaces. That provision is included in the reconciliation bill pending in the U.S. Senate. Last week, Sen. Joe Manchin (D-W.Va.) and Senate Majority Leader Chuck Schumer (D-N.Y.) reached an agreement on the reconciliation bill, according to Amber Philips at The Washington Post. The current formal name of the reconciliation bill is the Inflation Reduction Act, according to reporting from Tony Romm of The Washington Post on Tuesday (Aug. 2). 

Brandon Lee reported for Bloomberg Government that the reconciliation bill would extend federal subsidies for ACA premiums for three years (2023, 2024 and 2025). Those subsidies were due to end on Dec. 31, which would push ACA premiums up sharply and likely cause some consumers to lose coverage. The subsidies were enacted last year when Congress passed the American Rescue Plan Act, as we reported in a blog post in March 2021, “Resources for journalists on how the American Rescue Plan will reduce the number of uninsured Americans.” The ARPA included about $34 billion to fund what HHS called the ACA’s most significant expansion since Congress passed the law known as Obamacare in 2010. 

The ASPE report showed that 26.4 million people were uninsured in the first quarter of 2022, compared with an estimated 31.6 million people were who uninsured throughout 2020, thus indicating that some 5.2 million people gained coverage in that period. ASPE noted, however, that these numbers were based on a conservative estimate of the number of people who gained coverage since the fourth quarter of 2020. When ASPE compared the number of uninsured in the first quarter of this year with the number who were uninsured in the last quarter of 2020, the estimated number gaining coverage rose to 7.2 million, the report added.

Among the 5.2 million people who gained coverage between 2020 and March of this year, 4.1 million were adults ages 18 to 64, and 1 million were children ages 0 to 17. The percentage of adults ages 18 to 64 who were uninsured dropped from 14.5% in late 2020 to 11.8% early this year, ASPE reported. The percentage of children ages 0 to 17 who were uninsured dropped from 6.4% in late 2020 to 3.7% early this year. 

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