HEALTH INSURANCE: 30.4 million uninsured in US as of 2018 according to NCHS estimates

In 2018, 30.4 million persons of all ages (9.4%) were uninsured at the time of interview – not significantly different from 2017, but 18.2 million fewer persons than in 2010.”

The number of people without health insurance in 2018 was 30.4 million, or 9.4 percent of the civilian noninstitutionalized population, according to national estimates from the U.S. National Center for Health Statistics.  This compares with estimates of 48.6 million uninsured, or 16 percent of the population in 2010, when the Affordable Care Act was passed.  During the same period, the number of uninsured children decreased by 2 million or a decrease from 7.8 to 5.2 percent of children.

Source: Cohen, R.A., Terlizzi, E.P., and Martinez, M.E. (2019, May). Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2018. National Health Interview Survey Early Release Program. Click here for free full text:  https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201905.pdf  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

UNINSURED: 28.1 million lack health insurance in 2017

The number of Americans of all ages who do not have health insurance coverage has decreased from 48.6 million in 2010 to 28.1 million in early 2017, according to survey data collected each year by the National Center for Health Statistics.  This represents a decrease from 16 percent of the population in 2010 to 8.8 percent in 2017.

About 2 million children (aged under 18 years) gained health insurance coverage in this same time period — 5.8 million had no health insurance coverage in 2010 compared to 3.9 million in early 2017.

Comparative figures going back to 1997 are also provided in this report.

Source: Norris, T., Clarke, T.C., and Schiller, J.S. (2017, September). Early release of selected estimates based on data from the January-March 2017 National Health Interview Survey. National Health Interview Survey early release program. National Center for Health Statistics. Click here: https://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201709.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

UNINSURED: 48.3 million in 2010 dropped to 28.7 million in 2015 (U.S. national data for non-elderly population)

In 1972, the earliest year shown in this source, there were 30.7 million Americans under age 65 who did not have health insurance.  This number has varied somewhat from year to year – sometimes dropping, sometimes rising – but reached the highest number (48.3 million) in 2010.  In 2015, the number of uninsured Americans under 65 who were uninsured dropped to 28.7 million.  Here are some of the years shown in this source:

Number of Persons Uninsured (under 65 years old)

• 30.7 million  1972 (the earliest year)
• 23.0 million  1978 (the lowest year)
• 48.3 million  2010 (the highest year)
• 28.7 million  2015 (the most recent year)

Source: U.S. National Center for Health Statistics. (2017, February). National Health Interview Survey: Long-term trends in health insurance coverage. Click here: https://www.cdc.gov/nchs/data/nhis/earlyrelease/trendshealthinsurance1968_2015.pdf   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

HEALTH INSURANCE : 10 states with highest number of uninsured in 2014

These are authoritative numbers from the Medicaid and CHIP Payment and Access Commission that compare each state according to the number of uninsured residents in 2014 compared to 2013.

States with Highest Number of Uninsured (2014)

1. 5,047,000 Texas
2. 4,767,000 California
3. 3,245,000 Florida
4. 1,697,000 New York
5. 1,568,000 Georgia
6. 1,276,000 North Carolina
7. 1,238,000 Illinois
8. 1,065,000 Pennsylvania
9.    965,000 New Jersey
10.    955,000 Ohio

US Total = 36,670,000 (2014) – which represents a drop of 8,510,000 from 2013 to 2014 nationally.

States with Highest Percentage of Uninsured (2014)

1. 19.1 percent Texas
2. 17.2 percent Alaska
3. 16.6 percent Florida
4. 15.8 percent Georgia
5. 15.4 percent Oklahoma
6. 15.2 percent Nevada
7. 14.8 percent Louisiana
8. 14.5 percent Mississippi
9. 14.5 percent New Mexico
10. 14.2 percent Montana

US Total = 11.7 percent (2014) – which represents a drop of 2.8 percent from 2013 to 2014 nationally.

Source: Medicaid and CHIP Payment and Access Commission (2016, Mar.). Report to Congress on Medicaid and CHIP (p. 47). Washington, D.C.: MACPAC.  Click here for full text https://www.macpac.gov/wp-content/uploads/2016/03/March-2016-Report-to-Congress-on-Medicaid-and-CHIP.pdf

Of Related Interest: Collins, S.R., Gunja, M. and Beutel, S. (2015, Sept. 16). New Census data show the number of uninsured Americans dropped by 8.8 million. The Commonwealth Fund Blog. http://www.commonwealthfund.org/publications/blog/2015/sept/us-census-data-shows-uninsured-americans-drop Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

 

 

 

MEDICAL BILLS: Percent of people under 65 who cannot pay their medical bills at all is decreasing: US national data

These are the most recent survey data from the federal government’s National Health Interview Survey.

Percent of people (aged under 65) who live in families that have medical bills they cannot pay at all

• 11.3 percent 2011
• 11.4 percent 2012
• 10.6 percent 2013
•   9.8 percent 2014
•   8.8 percent 2015 (Jan-June)

Source: U.S. National Center for Health Statistics. (2015, Dec.). National Health Interview Survey early release program. http://www.cdc.gov/nchs/data/health_policy/bills_unable_to_pay_at_all_2011_2015.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

UNINSURED: Number of Americans lacking health insurance has decreased to 28.5 million in 2015

The number of Americans without health insurance has been decreasing, according to a survey conducted each year by the National Center for Health Statistics.  In 2010, there were an estimated 48.6 million Americans without health insurance.  As of the first half of 2015, that number had dropped to 28.5 million.  Let’s do the math.  That’s an improvement of 20 million people.

And for children, the results are also heartening.  In 2010, an estimated 5.8 million children were uninsured.  By the first half of 2015, that number had decreased to 3.3 million.  An improvement of 2.5 million.

Uninsured at the Time They Were Surveyed (all ages)

• 48.6 million, or 16 percent (2010)
• 46.3 million, or 15.1 percent (2011)
• 45.5 million, or 14.7 percent (2012)
• 44.8 million, or 14.4 percent (2013)
• 36 million, or 11.5 percent (2014)
• 28.5 million, or 9 percent (first half 2015)

These are federal government estimates based on the results of a sample survey of the civilian noninstitutionalized population of the United States.

Source:  Martinez, M.E., and Cohen, R.A. (2015, Nov.). Health insurance coverage: Early release of estimates from the National Health Interview Survey, January-June 2015. National Health Interview Survey early release program. Retrieved from http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201511.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

ACA Insurance Expansion and Uncompensated Hospital Care Costs

Hospital uncompensated care costs were $7.4 billion less in 2014 than they would have been if insurance coverage had remained at 2013 levels. That’s according to an updated analysis by HHS, based on estimated 2014 growth in insurance coverage due to the Affordable Care Act. It’s a 21% decrease in hospital uncompensated care between 2013 and 2014.

Medicaid expansion accounted for a significant portion of the uncompensated cost savings in states that expanded Medicaid versus those states that didn’t. An additional $1.4 billion in uncompensated costs might have been saved if the the non-expansion states had increased Medicaid coverage.

Here are the numbers from the report:

Furthermore, HHS analyzed hospital financial reports and found the volume of uninsured/self-pay admissions has fallen in major hospital systems, with a significant drop in states with Medicaid expansion.

 

Source: Insurance expansion, hospital uncompensated care, and the Affordable Care Act. US Dept. of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, March 23, 2015. http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_UncompensatedCare.pdf

Related resources:

Economic impact of the Medicaid expansion. US Dept. of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, March 23, 2015. http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_MedicaidExpansion.pdf

Uncompensated hospital care cost fact sheet. American Hospital Association, Jan. 2015. http://www.aha.org/content/15/uncompensatedcarefactsheet.pdf

See also earlier post: https://aharesourcecenter.wordpress.com/2014/09/26/impact-of-insurance-expansion-on-hospital-uncompensated-costs-in-2014/

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

What percent of the U.S. population is uninsured?

The most current federal government figures on the extent of the U.S. population that is without health insurance coverage indicate the following for the first half of 2014:

• 27 million (or 8.7 percent of the population) had been uninsured for more than a year
• 38 million (or 12.2 percent of the population) were without insurance at the time that they were interviewed for the survey
• 54 million (or 17.3 percent of the population) said that they had been uninsured at some time during the past 12 months

Interestingly, the numbers for the most recent time period — that is, from January to June 2014 – show a decrease in the number of people without health insurance in each of these three categories since 2009.

This data report also looks at the distribution of U.S. residents who are uninsured, have some type of public plan, or have private health insurance.

Source: Martinez, M.E., and Cohen, R.A. (2014, Dec.). Health insurance coverage: early release of estimates from the National Health Interview Survey, January-June 2014. National Health Interview Survey Early Release Program. Retrieved from http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201412.pdf Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

Impact of Insurance Expansion on Hospital Uncompensated Costs in 2014

See update at https://aharesourcecenter.wordpress.com/2015/03/23/aca-insurance-expansion-and-uncompensated-hospital-care-costs/

A new federal report examines the impact so far of health reform’s expanded health care coverage on uncompensated costs incurred by hospitals. With an estimated 8 million increase in the number of people covered by Medicaid and a 10.3 million decrease in the uninsured population, hospitals may lower their overall uncompensated costs by $5.7 billion (16%) this year.

Other key findings include:

• Volumes of uninsured/self-pay hospital admissions and emergency visits have fallen significantly, especially in Medicaid expansion states.
• The number of hospital admissions covered by Medicaid have risen, but mostly in Medicaid expansion states.

Source: DeLeire T and others. Impact of insurance expansion on hospital uncompensated costs in 2014. ASPE Issue Brief [US Dept. of Health and Human Services, Office of the Assistant Secretary for Planningg and Evaluation], Sept. 24, 2014. http://aspe.hhs.gov/health/reports/2014/UncompensatedCare/ib_UncompensatedCare.pdf

Related resource:Uncompensated hospital care cost fact sheet. American Hospital Association, Jan. 2014. http://www.aha.org/content/14/14uncompensatedcare.pdf

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

Another Update: Can Hospitals Pay Patient Health Insurance Premiums?

Here’s what’s new since the last update on whether or not a hospital can pay the health insurance premium for a patient:

Where federal regulators stand on third party payments of patient health insurance premiums has not been clearcut. Based on a letter from the Centers for Medicare & Medicaid Services on May 21, the American Hospital Association has advised members that “payments from private, not-for-profit foundations to qualified health plans (QHPs) on behalf of individuals who enroll in coverage via the Health Insurance Marketplaces are not prohibited.” However, AHA also points out there is no federal mandate that qualified health plans must accept premium subsidies from hospitals.

The insurance industry represented by America’s Health Insurance Plans wants premium support payments to be made only through independent foundations and not directly from hospitals or hospital-affiliated foundations. Insurers fear third-party premium payments for already sick patients could unfavorably skew the insurance pool and drive up costs.

Nonetheless, some hospitals are moving ahead to assist patients. The South Florida Hospital and Healthcare Association and the Healthcare Association of New York State are each looking at coordinating third party premium support options for their members.

Sources:

HHS confirms payments from foundations to QHPs are not prohibited. American Hospital Association Legal Advisory, June 5, 2014. http://www.aha.org/advocacy-issues/tools-resources/advisory/2014/140605-legal-adv.pdf  [AHA members only]

Sebelius K. Letter to R. Umbdenstock, American Hospital Association, re: qualified health plan issuers accepting premium and cost-sharing payments from third parties. Secretary of Health and Human Services, May 21, 2014. http://www.aha.org/content/14/140521-sebelius-umbdenstock.pdf

Appleby J. Hospitals seek to help consumers with Obamacare premiums. Kaiser Health News, Aug. 14, 2014. http://www.kaiserhealthnews.org/Stories/2014/August/14/Hospitals–Seek-To-Help-Consumers-With-Obamacare-Premiums.aspx

Related sources:

Office of Inspector General, Dept. of Health and Human Services. Supplementary special advisory bulletin: independent charity patient assistance programs. Federal Register 79(104):31120, May 30, 2014. http://t.co/xyGQ6O86yt

Clark C. Hospitals begin subsidizing exchange premiums via third parties. HealthLeaders Media, May 28, 2014. http://www.healthleadersmedia.com/page-1/HEP-304974/Hospitals-Begin-Subsidizing-Exchange-Premiums-via-Third-Parties

Caramenico A. Sebelius OKs premium payments from third parties. FierceHealthPayer, May 23, 2014. http://www.fiercehealthpayer.com/story/sebelius-oks-premium-payments-third-parties/2014-05-23

Jost T. Implementing health reform: third-party payments and reference pricing. Health Affairs Blog, May 22, 2014. http://healthaffairs.org/blog/2014/05/22/implementing-health-reform-third-party-payments-and-reference-pricing/

Carlson J. HHS warns that premium-assistance charities must be independent. Modern Healthcare, May 22, 2014.  http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCIQFjAA&url=http%3A%2F%2Fwww.modernhealthcare.com%2Farticle%2F20140522%2FNEWS%2F305229964&ei=S26bU9i1HM6dyASf-ILIDA&usg=AFQjCNHyKUVKd2VEJYQmQWzExf3jDuwlNQ&bvm=bv.68911936,d.aWw

Miller JS. Letter to Marilyn Tavenner, Centers for Medicare & Medicaid Services, re: Patient Protection and Affordable Care Act; third party payment of qualified health plan premiums – (CMS-9943-IFC) AHIP comments. America’s Health Insurance Plans, May 13, 2014. http://www.regulations.gov/contentStreamer?objectId=09000064816f7ae5&disposition=attachment&contentType=pdf

CMS interim final rule: premium subsidies. American Hospital Association Legal Advisory, April 8, 2014. http://www.aha.org/advocacy-issues/tools-resources/advisory/2014/140408-legal-adv.pdf  [AHA members only]

Centers for Medicare and Medicaid Services. Patient protection and affordable care act: third party payment of qualified health plan premiums; interim final rule with comment period. Federal Register 79(53):15240, March 19, 2014. https://www.federalregister.gov/articles/2014/03/19/2014-06031/patient-protection-and-affordable-care-act-third-party-payment-of-qualified-health-plan-premiums

HHS issues interim final rule on premium subsidies; continues to discourage insurers from accepting premium support from hospitals. American Hospital Association Special Bulletin, March 14, 2014. http://www.aha.org/advocacy-issues/bulletin/2014/140314-bulletin.shtml [AHA members only]

Centers for Medicare and Medicaid Services. Third party payments of premiums for qualified health plans in the marketplaces. Feb. 7, 2014. http://www.aha.org/content/14/140604-aha-cms-faq.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org