Progress Stalled: New Census Data Shows Uninsured Rates Fail to Decrease
As public health advocates continue to defend the Affordable Care Act from attacks in Congress and the courts, rates of health care uninsurance in the United States have remained stagnant, with wide disparities across populations, according to the latest data from the US Census Bureau.
Although US health insurance rates have been growing in recent years, they stalled in 2017, leading to concerns about access to care.
Photo by Bowdenimages, courtesy iStockphoto.
The “Income, Poverty and Health Insurance Coverage in the United States: 2017” report, released September 12, 2018, shows that 28.5 million Americans lacked insurance in 2017 compared with 28.1 million in 2016, which is a statistically insignificant difference. Meanwhile, the number of Americans with health insurance coverage increased by 2.3 million, with more than 91% of people insured at some point in 2017. More people were covered by private health insurance than government health insurance, at 67.2% and 37.7%, respectively. Among people with health coverage, 56% had employer-based insurance, 9.3% were covered by Medicaid, and 17.2% were covered by Medicare.
Although most people did have some form of health insurance from 2016 to 2017, the Census figures indicated large disparities in rates of coverage. Data from the American Community Survey, released September 13, 2018, show that uninsurance rates varied greatly across states, from 2.8% in Massachusetts to 17.3% in Texas. The percentage of uninsured people decreased in 3 states and increased in 14 states, with a disproportionate share of uninsured people residing in the South. Overall, the rate of uninsurance was lower in states that expanded Medicaid.
Most uninsured people were working-age adults aged 19 to 64 years, accounting for nearly 85% of people without health insurance. More than half of uninsured people were male and were more likely to have less than a high school education and to be low income. Almost 94% of Whites had health coverage, followed by about 93% of Asians, 89% of Blacks, and 84% of Hispanics.
—Julia Haskins
To read the full story, visit http://thenationshealth.aphapublications.org/content/48/9/1.1
Navigators Continue Working to Get People Insured, Despite Cuts
The Trump administration has made numerous attempts over the past year to undermine the Affordable Care Act, from slashing advertising funds to shortening the annual open enrollment period. A critical blow has also been struck against the people who help consumers make informed decisions about their health insurance options and get enrolled.
Under the Affordable Care Act, health care navigators were established to provide no-cost education, outreach, and assistance to people seeking to enroll in the insurance marketplace and other government-sponsored health plans. Federal funding for navigator programs was cut by 43% in 2017, straining programs that guide people through the enrollment process.
“The navigators have been through a very rough time and that is unfortunately continuing,” Eliot Fishman, PhD, senior director of health policy at Families USA, told The Nation’s Health. Navigator grantees throughout the United States have been under increased pressure to serve community members with less financial support from the federal government.
To fill in the gaps in service, some navigators are using complementary measures to inform consumers about health insurance enrollment. One strategy is partnering with organizations in the health care and public health sectors to offer cross-cutting support. Such is the case for the United Way of Metropolitan Chicago’s navigator program, which uses community partnerships to help consumers. “We’ve been seeing a lot of collaboration happening as a result of these [funding] cuts,” Latisha Thomas, MNA, MBA, a grant manager at the United Way of Metropolitan Chicago, told The Nation’s Health.
At AIDS Alabama, navigators are also stretching their resources. The navigator grantee did not experience significant funding cuts last year, although it is bracing for upcoming obstacles, said Matthew Pagnotti, director of policy and advocacy at the organization. He said that AIDS Alabama will likely need more help from volunteers and other groups to get people enrolled.
Navigator programs such as AIDS Alabama may also have to cut back on in-person assistance, which could be detrimental to enrollment numbers. Offering one-on-one support is key to helping people understand all the complicated factors involved in signing up for health insurance, and it could mean the difference between being covered or not, Pagnotti said. “Without being able to provide that in-depth assistance, I’m just worried about that impact on insurance coverage,” he told The Nation’s Health.
The coming year will see even more attacks on the Affordable Care Act, beginning in January with the repeal of the individual mandate that requires all Americans to carry health insurance or pay a fine. Its loss will result in 4 million more people uninsured in 2019, according to the Congressional Budget Office.
—Julia Haskins
To read the full story, visit http://thenationshealth.aphapublications.org/content/48/9/1.2.