Three years after the Affordable Care Act’s coverage expansion took effect, the number of Americans without health insurance fell to 28.1 million in 2016, down from 29 million in 2015, according to a federal report released this week.
The latest numbers from the U.S. Census Bureau showed the nation’s uninsured rate dropped to 8.8 percent. It had been 9.1 percent in 2015.
Both the overall number of uninsured and the percentage are record lows.
In Florida, the proportion of uninsured fell to 12.5 percent, from 13.3 percent the previous year and 20 percent in 2013. It’s a significant improvement. But the rate would have been lower had Gov. Rick Scott and the Florida Legislature not prevented the expansion of Medicaid, which the federal government would have funded almost entirely for several years. As a result, Florida’s rate of uninsured remains the fifth worst in the nation, exceeded only by those of Alaska, Georgia, Oklahoma and Texas. All those states had turned down Medicaid money. Alaska joined 30 other states with the expansion in 2015.
The actual number of people without insurance in Florida is 2.5 million, down from 3.8 million in 2013.
The latest figures from the Census Bureau effectively close the book on President Barack Obama’s record on lowering the number of uninsured. He made that a linchpin of his 2008 campaign, and his administration’s effort to overhaul the nation’s health system through the ACA focused on expanding coverage.
When Obama took office in 2009, during the worst economic recession since the Great Depression, more than 50 million Americans were uninsured, or nearly 17 percent of the population.
The number of uninsured has fallen from 42 million in 2013 — before the ACA in 2014 allowed states to expand Medicaid, the federal-state program that provides coverage to low-income people, and provided federal subsidies to help lower- and middle-income Americans buy coverage on the insurance marketplaces. The decline also reflected the improving economy, which has put more Americans in jobs that offer health coverage.
The dramatic drop in the uninsured over the past few years played a major role in the congressional debate over the summer about whether to replace the 2010 health law. Advocates pleaded with the Republican-controlled Congress not to take steps to reverse the gains in coverage.
The Census numbers are considered the gold standard for tracking who has insurance because the survey samples are so large.
The uninsured rate has fallen in all 50 states and the District of Columbia since 2013, although the rate has been lower among the 31 states that expanded Medicaid as part of the health law. The lowest uninsured rate last year was 2.5 percent in Massachusetts and the highest was 16.6 percent in Texas, the Census Bureau said. States that expanded Medicaid had an average uninsured rate of 6.5 percent compared with an 11.7 percent average among states that did not expand, the Census Bureau reported.
More than half of Americans — 55.7 percent — get health insurance through their jobs. But government coverage is becoming more common. Medicaid now covers more than 19 percent of the population and Medicare nearly 17 percent.
–Kaiser Health News and FlaglerLive
Highlights from the Census Bureau report:
- The uninsured rate decreased between 2015 and 2016 by 0.3 percentage points. In 2016, the percentage of people without health insurance coverage for the entire calendar year was 8.8 percent, or 28.1 million, lower than the rate and number of uninsured in 2015 (9.1 percent or 29.0 million).
- The percentage of people with health insurance coverage for all or part of 2016 was 91.2 percent, higher than the rate in 2015 (90.9 percent).
- In 2016, private health insurance coverage continued to be more prevalent than government coverage, at 67.5 percent and 37.3 percent, respectively. Of the subtypes of health insurance coverage, employer-based insurance covered 55.7 percent of the population for some or all of the calendar year, followed by Medicaid (19.4 percent), Medicare (16.7 percent), direct-purchase (16.2 percent), and military coverage (4.6 percent).
- Between 2015 and 2016, the rate of Medicare coverage increased by 0.4 percentage points to cover 16.7 percent of people for part or all of 2016 (up from 16.3 percent in 2015). There was no statistically significant difference between 2015 and 2016 for any other subtype of health insurance.
- Between 2015 and 2016, the percentage of people without health insurance coverage dropped for most ages under 65, with generally larger decreases for working-age adults (aged 19 to 64).
- The percentage of uninsured children under age 19, 5.4 percent, did not significantly change between 2015 and 2016.
- In 2016, the uninsured rate for children under age 19 in poverty, 7.0 percent, was higher than the uninsured rate for children not in poverty, 5.0 percent.
- In 2016, non-Hispanic Whites had the lowest uninsured rate among race and Hispanic origin groups, at 6.3 percent. The uninsured rates for Blacks and Asians were higher than for non-Hispanic Whites, at 10.5 percent and 7.6 percent, respectively. Hispanics had the highest uninsured rate, at 16.0 percent.
- Between 2015 and 2016, the percentage of people without health insurance at any time during the year fell 0.4 percentage points for non-Hispanic Whites, down to 6.3 percent. There was no statistical change in the uninsured rate for Blacks, Asians, or Hispanics during this period.
- Between 2015 and 2016, the percentage of people without health insurance coverage at the time of interview decreased in 39 states. Eleven states and the District of Columbia did not have a statistically significant change in their uninsured rate.