Health Insurance Coverage: NHIS

Since the Supreme Court have me another reprieve, I’m sitting in a hotel preparing to give two talks instead of writing pieces about the meaning of the Supreme Court ruling. I’m grateful, because I’d rather not focus on that today. In fact, I’m tired of talking about what’s going to happen. We’ll know when we know.

On that note, I’d much rather discuss what is going on now. Thankfully, the CDC released the early estimates form the 2011 National Health Insurance Survey. Let’s look:

  • Once each year, this quarterly report presents health insurance coverage rates for selected states. In 2011, the percentage of persons who were uninsured at the time of interview among the 32 states shown ranged from 3.9% in Massachusetts to 22.6% in Nevada.
  • In 2011, 46.3 million persons of all ages (15.1%) were uninsured at the time of interview, 58.7 million (19.2%) had been uninsured for at least part of the year prior to interview, and 34.2 million (11.2%) had been uninsured for more than a year at the time of interview.
  • In 2011, the percentage of children under age 18 years who were uninsured at the time of interview was 7.0%.
  • Among adults aged 19–25, the percentage uninsured at the time of interview decreased from 33.9% (10 million persons) in 2010 to 27.9% (8.4 million) in 2011.
  • Among adults aged 19–25, 56.2% were covered by a private plan in 2011, an increase from 2010 (51.0%).
  • In 2011, 29.0% of persons under age 65 with private health insurance at the time of interview were enrolled in a high deductible health plan (HDHP), including 9.2% who were enrolled in a consumer directed health plan (CDHP). More than 50% of persons with a private plan obtained by means other than through employment were enrolled in an HDHP. An estimated 21.4% of persons with private health insurance were in a family with a flexible spending account (FSA) for medical expenses.

Uninsurance is down overall from 16% in 2010 to 15.1% in 2011. That’s great. But a lot of it comes from young adults getting on their family plan. The number of adults aged 19-25 who are uninsured dropped by 1.6 million, and way more of them went to private insurance than public insurance.

The bottom line is that we have problems with access and insurance that aren’t going away. The private market is eroding (except for young adults). If you want to keep that market around, you need to shore it up. The ACA will do that. If you get rid of the ACA, not only do all the potential new insureds from the exchanges vanish, but so do the real young adult customers who have joined the rank of privately insured recently.

ARGH. I wound up talking about “what might happen” anyway. So hard to avoid…


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