Number of Uninsured Fell in 2011, Largely Due to Health Reform and Public Programs
The largest increases in coverage came among young adults, largely due to a provision of the health reform law (officially the Affordable Care Act, or ACA) allowing adult children up to age 26 to stay on their parents’ private insurance plans.
Forty percent of the decline in the number of uninsured people occurred among individuals aged 19 to 25; some 539,000 fewer 19- to 25-year-olds were uninsured in 2011 than in 2010. This allowed the overall percentage of non-elderly people with private coverage to remain steady, rather than to decline, for the first time in 10 years. (Private coverage increased among those under 25 by 1.6 percentage points, while declining among those aged 25-64, by 0.4 percentage points, with the two effects offsetting each other.)
The overall gains in coverage also reflected a significant increase in the number and percentage of Americans with public health insurance — principally through Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). More people enrolled in these programs as the population aged and employer-based coverage continued to erode among those aged 25 to 64.
In the case of Medicaid and CHIP, federal policies, including a temporary increase in Medicaid funding for states through June 2011 (which policymakers included in the 2009 Recovery Act and later extended) and health reform’s requirement that states maintain their eligibility levels and enrollment procedures, likely enabled these programs to cover more low-income people during the slow economic recovery. Medicaid and CHIP enrollment tends to continue rising for a few years after the end of a recession.
Substantially more progress in reducing the ranks of the uninsured should occur starting in 2014. Due to health reform, 30 million people who would otherwise be uninsured will obtain health coverage by 2022, according to Congressional Budget Office (CBO) estimates, as the law’s principal provisions expanding coverage have an increasing impact.
The new Census figures show that:
- The overall number of uninsured Americans fell in 2011 by 1.3 million, to 48.6 million.
- The share of Americans without insurance coverage fell from 16.3 percent in 2010 to 15.7 percent in 2011.
- 2.3 million more low-income individuals were enrolled in Medicaid and CHIP in 2011 than in 2010, helping to reduce the number without health insurance.
- The share of African Americans without insurance coverage fell from 20.8 percent in 2010 to 19.5 percent in 2011. Whites and Asian-Americans also experienced notable coverage gains, while Hispanics did not.