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U.S. Uninsured Rate Sticks at Around 9%

A little more than 9% of Americans were uninsured during the first 9 months of 2018, according to survey data released Wednesday by the National Center for Health Statistics.

A total of 29.7 million people of all ages (9.2%) were uninsured at the time of being interviewed — “not significantly different from 2017, but 18.9 million fewer persons than in 2010,” the authors noted. Among adults, ages 18-64, 13.0% were uninsured at time of interview, 19.7% had public coverage, and 69.0% had private health insurance coverage. (Numbers add up to more than 100% because some patients had both public and private coverage and were included in both categories.)

The authors also looked at children, ages 0-17 years, and found that 4.9% were uninsured, 42.5% had public coverage, and 54.1% had private health insurance coverage. All estimates come from the agency’s National Health Interview Survey, which includes data for 61,484 people.

The investigators also examined longer-term trends and found that, although the percentage of uninsured adults (ages 18-64) had been increasing, in more recent months, it declined and then stabilized. Similarly, the percentage of adults with public coverage recently stabilized following a decrease.

As for children, their rate of being uninsured had been dropping but more recently has leveled off, and rates for both private and public insurance coverage for children have also stabilized, the researchers found.

They also looked at how adults were insured, including enrollment trends in the Affordable Care Act health insurance marketplaces. Interestingly, “in the first 9 months of 2018, adults 18-64 in states with a federally facilitated marketplace were more likely to be uninsured than those in states with a state-based marketplace or states with a partnership marketplace,” the authors noted. In addition, “among adults 18-64, significant decreases were observed in the uninsured rates from 2013 through the first 9 months of 2018 in states with a state-based marketplace, a partnership marketplace, and a federally facilitated marketplace.”

The popularity of high-deductible health plans (HDHPs) has been going up in recent years, according to the researchers. “Among those with private health insurance, enrollment in HDHPs has generally increased since 2010,” they wrote. In fact, during the first 9 months of 2018, 45.6% of those under age 65 with private health insurance were enrolled in an HDHP — these included both HDHPs alone as well as HDHPs combined with health savings accounts, a combination known as a consumer-directed health plan (CDHP). CDHPs have been gaining in popularity recently, rising from 18.2% of those with private health insurance in 2017 to 20.6% in the first 9 months of 2018.

On the other hand, the percentage of those with private insurance who were using an HDHP without a health savings account didn’t change significantly, dropping slightly from 25.5% in 2017 to 25.0% in the first 9 months of 2018, the researchers said.