Figuring out why fewer were uninsured in 2011

by Robert I. Field, Ph.D., J.D., M.P.H.

Here’s some good news about health care for a change. Fewer Americans lacked health insurance in 2011 than in 2010 - almost a million-and-a-half of them.

The Census Bureau reported last week that that the number of people without coverage fell from 49.9 million to 48.6 million. That brought the percentage of uninsured down from 16.3% to 15.7%. 

In a follow-up analysis released this week, the Bureau reported that rates of uninsurance fell in 20 states, while only two saw statistically significant increases.

This is a dramatic turnaround. Just two years ago, the Bureau found one of the steepest increases in uninsurance in history. In September 2010, it reported that the number of Americans without health insurance skyrocketed between 2008 and 2009 from 46.3 million to an all-time high of 50.7 million. That raised the percentage of uninsured from 15.4% to 16.7% for one of the largest single year increases since health insurance trends were first tracked in 1987. 

What happened? Is this a taste of Obamacare in action?

The Bureau believes that several factors were at work. One is that government programs are covering more people. The struggling economy has thrown many into poverty, making them eligible for Medicaid. And the wave of aging baby boomers has increased enrollment in Medicare. The percentage of Americans with government insurance rose to 32.2% in 2011 from 31.2% a year earlier.

Another is that health care inflation has moderated. It stood at only 4% in 2011, the lowest rate in many years. That deterred some employers from dropping coverage. Last year was the first one in a decade in which the percentage of people with private coverage did not fall.

But a third factor was definitely Obamacare. The biggest drop in uninsurance was for the 19 to 25 year old age group. Their rate fell from 29.8% to 27.7%.

Young adults were among the first to benefit from health reform, which gave them the right to stay on their parents’ policies until age 26. An estimated three million have taken advantage of that provision, many of whom would be uninsured without it.

When Obamacare fully takes effect in 2014, it will extend coverage to about 30 million more people. In the meantime, it seems to be off to a good start. 

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