Uninsured Rates Among Americans Have Decreased

The United States experienced a decline in the uninsured rate of Americans without healthcare coverage in 2020 and 2021. During this time, younger adults ages 19-49; Latino, American Indian and Alaska natives, non-English speaking adults and those living in recently expanded Medicaid states; are among the larger groups that have seen most coverage gain.

This data was shared in a recent analysis conducted by the U.S. Department of Health and Human Services. Researchers examined data from the 2019 and 2021 American Community Survey and found that, nationally, the uninsured rate declined from 11.1% to 10.5%, a 0.7 percentage point change that represents more than 1.6 million people gaining coverage.

Individuals ages 19 to 34 were most likely to be uninsured in 2021 at 15%, followed by those ages 35 to 49 years at 13%, the analysis shared. Individuals with federal poverty level incomes between 100-138% had the greatest reduction in uninsured rates, decreasing 1.4% points from 17.7% to 16.3%, while those between the 139-249% poverty level had a decrease of 1%.

In a time of economic and public health distress caused by the COVID-19 pandemic, the U.S. experienced this drop of uninsured rates due to changes in federal and state coverage policies for Medicaid and the Marketplace. These efforts combat the ongoing barriers faced of affordability and awareness.

To address these two primary barriers to coverage, the Biden-Harris Administration implemented the American Rescue Plan, which expands premium tax credits for Marketplace coverage and increases grants awarded to Navigators in Federally-Facilitated Marketplaces to train and certify over 1,500 Navigators.

According to the analysis, nearly 6 million new consumers signed up for coverage during the first full year of the Biden-Harris Administration through the Marketplaces nationwide and during the 2021 Special Enrollment Period (SEP) and the 2022 Open Enrollment Period (OEP). This includes 2.8 million people who newly enrolled during the 2021 SEP, and more than 3 million who newly enrolled during the 2022 OEP. A record-breaking 14.5 million individuals signed up for health coverage during the 2022 OEP, 10.3 million of which were plan selections in states using the HealthCare.gov platform. As of January 11, 2023, nearly 15.9 million Americans – including 11.9 million people in states using HealthCare.gov – had selected a health plan for the 2023 OEP, the analysis said.

One key policy that has been in place for the past two years – the Medicaid continuous enrollment provision – will end starting in April 2023, under the recently passed Consolidated Appropriations Act, 2023. More than 15 million Medicaid and CHIP enrollees may be at risk for losing coverage, though efforts from the Marketplace coverage and the Inflation Reduction Act’s extension of the ARP’s enhanced tax credits through 2025 can mitigate the risk of becoming uninsured, the analysis said.

It’s important to note the American Community Survey is currently only available through the end of 2021. Data released from the NHIS showed that the uninsured rate reached an all-time low in the first quarter of 2022, but with a slight increase in the second quarter of 2022. These 2022 changes are not yet reflected.