Census Report: Health Coverage Keeps Rising

Sept. 16--The share of Americans who don't have health insurance dropped to 10.4 percent last year, the U.S. Census reported Wednesday in the most detailed look at health coverage since the main provisions of the Affordable Care Act took effect.

In 2014, 33 million people in the U.S. were uninsured, down from 41.8 million in 2013, according to the Census report. While other reports have shown a similar decline in the number of uninsured Americans -- and include more recent enrollment for 2015, not included in Wednesday's release -- the Census data is considered the gold standard.

Last year was the first that people began enrolling in health coverage on Obamacare's newly created marketplaces. The law subsidized the purchase of health insurance for some people, and expanded Medicaid to help cover more poor people. It also established a tax penalty for those who refused to buy coverage.

The rate of uninsured nationwide last year was down 2.9 percentage points from 2013. The trend was seen in plans bought by individuals (including those bought on the Obamacare exchanges), Medicaid, and even a slight uptick in Medicare. Employment-based insurance, the biggest category covering 54 percent of Americans, held steady.

Individual plans were up the most, to 14.6 percent last year, up 3.2 percentage points.

Drops in the rate of uninsurance were seen among nearly all income levels and races, although there were significant differences among groups. Hispanics, with by far the highest rate of uninsured, were down 4.5 percentage points, to 19.9 percent. Asians were down to 9.3 percent uninsured. The rate of uninsured blacks dropped 4.1 points, to 11.8 percent. Whites were down 2.1 points, to 7.6 percent.

People living in poverty were helped the most. Part-time employees also made big gains.

The other big difference from the health law was reflected in Medicaid, the federal-state program that states could choose to expand in order to cover more people who in the past weren't poor enough for the program, but still couldn't afford insurance.

The uninsured rate in New Jersey, where Gov. Christie was one of the first Republicans to accept the expansion, dropped 2.3 points to 10.9 percent in 2014.

In Pennsylvania, then-Gov. Tom Corbett first rejected expansion, then implemented a complex private-market alternative a year later, starting Jan. 1, 2015, shortly before he left office. Despite a bumpy start and Gov. Wolf's challenging transition to the kind of program envisioned by the Obama administration, 447,000 people have enrolled the state Department of Human Services reported.

That figure is not reflected in Wednesday's census report, which showed the state's uninsured rate for 2014 was down 1.3 percentage points, to 8.5 percent.

Pennsylvania and New Jersey have had among the lowest rates of uninsured in the nation.

Throughout the country, the uninsured rates have continued to fall through 2015, according to reports using more recent data. The Obama administration said in May that about 16.4 million people have gained coverage under the Affordable Care Act, a figure that includes sign-ups for coverage this year.

The majority of Americans don't rely on government insurance, and instead buy private coverage either through work or, increasingly, on Obamacare's exchanges. The Census report showed that the share of people enrolled in private health insurance last year increased to 66 percent in 2014, up from 64.1 percent a year before.

Enrollment in government-sponsored health plans rose as well, to 36.5 percent from 34.6 percent of the population a year before, boosted by the Affordable Care Act's provisions to expand Medicaid to more people at higher income levels.

Changes to the Census Bureau's survey methodology in 2013 make it difficult to compare with prior years. However, data from the Centers for Disease Control and Prevention appear to show a steady decline in the number of Americans without health insurance from 2010 to 2014, thanks to Obamacare coverage programs and the improving economy.

dsapatkin@phillynews.com

215-854-2617

@DonSapatkin

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