New data by the Census Bureau released on Wednesday showed a significant drop in the percentage of people without health insurance.  According to the new census report, the percentage of people without health insurance coverage decreased between 2013 and 2014 by 3.0 percent (actual 2.9 percent).  The data is based on the Bureau’s American Community Survey (ACS) and the Annual Social and Economic Supplement (ASES).  The figure represents the population that had no insurance throughout the year but is similar to the decrease in people who lacked insurance for a part of the year.

Looking at the numbers in reverse it means that the number of insured has increased to 89.6 percent. Of the population that has health insurance, employer-based insurance covered the most people (55.4 percent), followed by Medicaid (19.5 percent), Medicare (16.0 percent), direct-purchase (14.6 percent), and 4.5 percent had coverage through the military.  Those people buying directly represented the biggest area of increase in coverage which is a reflection of the impact of the ACA.

Between 2013 and 2014, every state and the District of Columbia experienced a decrease in their uninsured rate with those states opting not to expand Medicaid coverage seeing slower reductions in the percentage of uninsured.   In 2014, the percentage of uninsured children under age 19 was 6.2 percent which is a decrease from 7.5 percent in 2013. The uninsured rate for children under age 19 in poverty, 8.6 percent, was higher than the uninsured rate for children not in poverty, 5.6 percent.   Age is strongly associated with health insurance coverage.

In 2014, 98.6 percent of adults aged 65 years or over had some type of health insurance during the year, compared with 93.8 percent of children under age 19 and 85.7 percent of working-age adults aged 19 to 64 years Children under age 19 were covered by health insurance at a higher rate than working-age adults and at a lower rate than older adults.  Nearly 43 percent (42.6 percent) of children under age 19 had government coverage.  Some children were covered by both private and government coverage for all or part of the calendar year.

For children under age 19, the uninsured rate was greater with increasing age, with 4.0 percent for children under 1 year of age and 11.0 percent for 18year-olds. Among young adults between the ages of 19 and 25, the uninsured rate was 17.7 percent for 19-year-olds and 21.2 percent for 25-year-olds. For adults between ages 26 and 64, the uninsured rate declined generally across all ages from 25.1 percent for 26-year-olds to 8.8 percent for 64-year-olds.  This last data point is of particular importance in child welfare.

Under the ACA a young person leaving foster care is eligible for continued coverage under Medicaid to age 26.  Due to interpretations and technical challenges this mandated Medicaid coverage does not extend to a young person formerly in foster care if they have moved to another state unless that state choices to extend this coverage.   Senator Bob Casey (PA) introduced the Health Insurance for Former Foster Youth Act (S. 1852) that would provide a technical fix to the ACA that extended Medicaid to all former foster youth up to age 26 regardless of what state they move to later.