Post-ACA Coverage Estimates: Early Release of 2014 Full-Year NHIS

June 26, 2015: New insurance coverage estimates from the 2014 National Health Interview Survey (NHIS) Early Release Program show a 2.9 percentage-point decline in the national uninsured rate from 2013 to 2014 (from 14.4% to 11.5%). This continues a downward trend in the national uninsured rate that began in 2011 after a decade of general growth.

NHIS: What's New?

2014 marks the first time that full-year state-level NHIS estimates are available for all 50 states and the District of Columbia for all persons of all ages, those under age 65, and adults ages 18 to 64. Full-year state-level estimates are available for 40 states for children aged 0 to 17.

The overall uninsured rate fell significantly in 13 of these states from 2013 to 2014. The magnitude of these declines varied widely, ranging from a 3.0 percentage-point drop in Michigan (from 11.0% in 2013 to 8.0% in 2014) to a 12.5 percentage-point drop in West Virginia (from 20.1% in 2013 to 7.6% in 2014). In all, eight states saw an uninsurance drop of more than five percentage points.

Private Coverage Drove the Change Nationally

The drop in the national uninsured rate from 2013 to 2014 was driven by a 2.3 percentage-point increase in private coverage nationwide. At the state level, private health insurance coverage increased significantly from 2013 to 2014 in Arkansas, Georgia, Rhode Island, and West Virginia. Of these four states, Arkansas saw the largest growth in private coverage, with a year-over-year jump of 11.4 percentage points (from 50.2% in 2013 to 61.6% in 2014). 

Public coverage did not change significantly from 2013 to 2014 at the national level, and public coverage changed significantly in just one state—Oregon—where the rate climbed from 32.0 percent to 41 percent.

All Age Groups Saw Increases in Coverage

The national uninsured rate dropped among all age groups, but the decline was most pronounced among non-elderly adults (18 to 64 years old), who saw a 4.1 percentage-point reduction in their overall uninsured rate (from 20.4% in 2013 to 16.3% in 2014). The uninsured rate for children (0 to 17 years) nationwide decreased by one percentage point (from 6.5 % in 2013 to 5.5% in 2014). 

About the NHIS

The NHIS is conducted by the National Center for Health Statistics (NCHS), and its Early Release Program provides analytic reports and preliminary microdata files on an expedited schedule in order to provide early access to the most recent information from the NHIS. In addition to annual estimates, the Early Release Program provides quarterly estimates for each calendar year, incorporating three additional months of data for each quarter.