By Jeffrey H. Brochin, J.D.
No significant change in the 2018 figures (9.4 percent) over the 2017 estimates (9.1 percent) for the percentage of persons of all ages who were uninsured at the time of the interview.
The National Health Interview Survey Early Release Program results have been published by the National Center for Health Statistics covering 2018, revealing the percentage as well as numbers of non-institutionalized Americans who were lacking in health insurance coverage at the time the data was collected. The report provides full-year health insurance estimates for the United States and 17 selected states using 2018 National Health Interview Survey data which was broken down as to all ages, adults, and children. The 2018 estimates were based on data for 72,762 persons (Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2018, May 10, 2019).
Three estimates provided. The report included three estimates of lack of health insurance coverage as follows: (1) uninsured at the time of interview; (2) uninsured at least part of the year prior to interview (which includes persons uninsured for more than one year); and (3) uninsured for more than one year at the time of interview. Estimates of public and private coverage, coverage through exchanges, and enrollment in high-deductible health plans and enrollment in high-deductible health plans (HDHPs) and consumer-directed health plans (CDHPs) were also presented.
Survey highlights. Among the survey’s findings of uninsured populations in 2018 were the following:
- 30.4 million persons of all ages (9.4 percent) were uninsured at the time of interview—not significantly different from 2017, but 18.2 million fewer persons than in 2010.
- Among adults aged 18–64, 13.3 percent were uninsured at the time of interview, 19.4 percent had public coverage, and 68.9 percent had private health insurance coverage.
- Among children aged 0–17 years, 5.2 percent were uninsured, 41.8 percent had public coverage, and 54.7 percent had private health insurance coverage.
- Among adults aged 45–64, the percentage who were uninsured increased from 9.3 percent in 2017 to 10.3 percent in 2018.
- Among adults aged 18–64, 68.9 percent (136.6 million) were covered by private health insurance plans at the time of interview in 2018. This includes 4.2 percent (8.4 million) covered by private health insurance plans obtained through the health insurance marketplace or state-based exchanges pursuant to the Patient Protection and Affordable Care Act (ACA) (P.L. 111–148).
- The percentage of persons under age 65 with private health insurance enrolled in a high-deductible health plan increased from 43.7 percent in 2017 to 45.8 percent in 2018.
Short-term trends by race and ethnicity. The survey also determined that in 2018, 26.7 percent of Hispanic, 15.2 percent of non-Hispanic black, 9.0 percent of non-Hispanic white, and 8.1 percent of non-Hispanic Asian adults aged 18–64 lacked health insurance coverage at the time of interview. Significant decreases in the percentage of uninsured adults were observed from 2013 through 2018 for Hispanic, non-Hispanic black, non-Hispanic white, and non-Hispanic Asian adults. Hispanic adults had the greatest percentage point decrease in the uninsured rate from 2013 (40.6 percent) through 2018 (26.7 percent). For all groups, the percentage of persons who were uninsured at the time of interview did not change significantly from 2017 through 2018.
Short-term trends by age. Adults aged 25–34 were the most likely to lack health insurance coverage (17.0 percent) compared with the other age groups examined. Adults aged 45–64 were the least likely to be uninsured at the time of interview (10.3 percent). The percentage of those uninsured at the time of interview remained relatively stable from 2010 through 2013 for all age groups except adults aged 18–24. Among adults aged 18–24, the percentage who were uninsured decreased, from 31.5 percent in 2010 to 25.9 percent in 2011, and then remained stable through 2013. For adults aged 18–24, 25–34, and 35–44, the percentage who were uninsured generally decreased from 2013 through 2018. The magnitude of the decreases ranged from negative 6.5 percentage points for adults aged 35–44 to negative 10.0 percentage points for adults aged 18–24 and adults aged 25–34. Although there have been decreases since 2013, more recently, the percentage of uninsured from 2015 through 2018 has remained stable for most age groups. However, among adults aged 45–64, the percentage who were uninsured decreased, from 15.4 percent in 2013 to 8.8 percent in 2015, and then increased to 10.3 percent in 2018.
Selected demographics available. The report is updated quarterly and is part of the NHIS Early Release (ER) Program, which releases updated selected estimates that are available from the NHIS website at: https://www.cdc.gov/nchs/nhis.htm. Estimates for each calendar quarter, by selected demographics, are also available as a separate set of tables through the ER Program.
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