SHADAC Staff

p 612.624.4802
e shadac@umn.edu

2015 ACS: Variation in Public and Private Coverage at the State Level

The U.S. Census Bureau released its full statistical portfolio for the 2015 American Community Survey (ACS), including state-level information about health insurance coverage by coverage type.  

Public vs. Private Coverage: State Changes Varied from 2014 to 2015

The ACS found a 2.3 percentage-point national increase in health insurance coverage between 2014 and 2015, from 88.3% to 90.6%—an increase that was driven by nationwide increases in both public and private coverage during this time (from 33.2% to 34.7% and from 66.4% to 67.5%, respectively[1]).

The national overall coverage increase was mirrored by significant overall coverage increases in almost every state (with the exception of North Dakota, South Dakota, and Wyoming, none of which saw a significant change); however, there was variation among states in the prevalence and direction of year-over-year coverage changes with respect to public vs. private coverage (which includes individually-purchased and employer-sponsored coverage).

	Public Coverage Rates by State, All Ages, 2014-2015
•	Public coverage increased significantly in 34 states.
•	Public coverage decreased significantly in one state (North Dakota).
•	15 states and the District of Columbia saw no significant change in public coverage.

 

 

 

 

 

 

 

	Private Coverage Rates by State, All Ages, 2014-2015
•	Private coverage increased significantly in 30 states and the District of Columbia.
•	No state saw a significant decrease in private coverage.
•	20 states saw no significant change in private coverage.

 

 

 

 

 

 

 

 

 

 

 

 

Public vs. Private Coverage, All Ages: State Variation in 2015
In addition to the above inter-state variation in coverage changes between 2014 and 2015, there was wide variation in state levels of public and private coverage when looking at the 2015 estimates on their own.
•	New Mexico had the highest rate of public coverage in 2015, at 46.6%.
•	Utah had the lowest rate of public coverage in 2015, at 21.3%.
•	North Dakota reported the highest rate of private coverage in 2015, at 80.6%.
•	New Mexico saw the lowest rate of private coverage in 2015, at 54.6%.

 

 

 

 

 

 

 

 

More to Come

Stay tuned for more granular details about insurance coverage changes in the states from 2014 to 2015 via customized SHADAC tables examining coverage at the state and county level.  

Related Reading

ACS: Widespread State-Level Declines in Uninsurance, with Inter-State Variation Persisting
-SHADAC Blog, September 13, 2016

Census Bureau Experts Will Share Insights during September 21st SHADAC Webinar

On Wednesday, September 21st, SHADAC will host a webinar to examine the new 2015 estimates from the ACS and the Current Population Survey (CPS), with technical insight provided by researchers from SHADAC and the U.S. Census Bureau. Speakers will discuss the new national and state estimates, and attendees will learn when to use which estimates from which survey, how to access the estimates via Census reports and American FactFinder, and how to access state-level estimates from the ACS using SHADAC tables. Attendees will also have the opportunity to hear more about CPS employer offer and take-up estimates, for which three full years of data will be available. Speakers will answer questions from attendees after the presentations. 

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[1] Sum of public and private coverage estimates exceeds 100% because survey respondents may report more than one type of coverage.

2015 ACS Tables: State & County Uninsured Rates

The map on this page links to tables containing state and county uninsurance estimates for 2015.  These estimates come from the 2015 American Community Survey (ACS) via the U.S. Census Bureau’s American FactFinder (AFF) tool and were released on September 15, 2016. Due to sample size constraints, single-year ACS estimates are available at the county level only for counties with a population greater than 65,000.

Click on a state to see state and county uninsurance rates by characteristics (for example, age, race/ethnicity, and poverty level) for 2015 and comparison year 2014.

Click here to view uninsurance estimates for the United States.

Click here to view uninsurance estimates for Puerto Rico and its municipios.

Note: These tables present uninsured rates, which indicate the share of the population that is uninsured. For example, a 10 percent uninsured rate for adult women indicates that 10 percent of all adult women are uninsured. 

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Additional Estimates (50-State Comparisons)

Maps & Tables of Private, Public, & Uninsured Change from 2014 to 2015

• Private Coverage Rates by State, Change from 2014 to 2015, for All People
• Public Coverage Rates by State, Change from 2014 to 2015, for All People
• Uninsurance Rates by State, Change from 2014 to 2015, for All People
• Uninsurance Rates by State, Change from 2014 to 2015, for Children under Age 18

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About the ACS

The ACS is a household survey that began in 2005 and produces annually updated data on a variety of population characteristics, including health insurance coverage. In total, the ACS surveys approximately three million US households each year. An important feature of the ACS is that it includes a large enough sample for state‐level and sub‐state estimates.

The ACS began asking survey respondents about health insurance coverage during the 2008 calendar year. Specifically, the survey asks respondents about current coverage for each person in the respondent’s household. A person is categorized as “insured” if he or she has coverage at the point in time at which the survey is administered.

Why Aren’t Estimates Provided for All Counties?

Due to sample size constraints, single-year ACS estimates are available at the county level only for counties with a population greater than 65,000. 

How Are these Estimates Different from the Estimates that SHADAC Publishes Using Census Bureau Micro-Data Files?

Two definitions used by the Census Bureau to generate the tabulations above differ from those that SHADAC uses to generate tabulations for the SHADAC Data Center and the RWJF Data Hub.  The definitional differences are as follows:

   Family

• The Census Bureau defines a family as all related people in a household.
• SHADAC defines a family using a measure called the “Health Insurance Unit” (HIU), which includes all individuals who would likely be considered a family unit in determining eligibility for either private or public coverage.
• To learn more about the HIU, see SHADAC Brief #27, “Defining Family for Studies of Health Insurance Coverage.”

   Family Income

• The Census Bureau determines family income as a percentage of the Federal Poverty Level (FPL), which is a definition of poverty used primarily for statistical purposes.  For example, FPL is used to estimate the number of Americans living in poverty each year.
• SHADAC determines family income as a percentage of the U.S. Department of Health and Human Services’ Federal Poverty Guidelines (FPG), which is a measure used for administrative purposes.  For example, FPG is used to determine eligibility for federal programs such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP).
• To learn more about the difference between FPL and FPG, click here.

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SHADAC Staff

p 612.624.4802
e shadac@umn.edu

2015 ACS: Widespread State-level Declines in Uninsurance, with Inter-State Variation Persisting (Infographic)

The U.S. Census Bureau released new health insurance coverage estimates today from the American Community Survey (ACS). The new estimates show a nationwide drop in uninsurance from 11.7% in 2014 to 9.4% in 2015 (down 2.3 percentage points), translating to almost 7 million fewer uninsured Americans in 2015. This decline is consistent with the historic decrease seen between 2013 and 2014.

The ACS Estimates in Context

The findings from the 2015 ACS are consistent with findings from the Current Population Survey (CPS), which were also released today. The CPS, which is the official source for information on poverty, found that the percentage of all people who were uninsured for the entire calendar year fell 1.3 percentage points nationwide, from 10.4% in 2014 to 9.1% in 2015.  An early release of 2016 findings from the National Health Interview Survey (NHIS) showed stable uninsurance rates between the first quarter of 2015 and the same period in 2016.

Census Bureau Experts Will Share Insights during September 21st SHADAC Webinar

On Wednesday, September 21st, SHADAC will host a webinar to examine the new 2015 ACS and CPS estimates, with technical insight provided by researchers from SHADAC and the U.S. Census Bureau. Speakers will discuss the new national and state estimates, and attendees will learn when to use which estimates from which survey, how to access the estimates via Census reports and American FactFinder, and how to access state-level estimates from the ACS using SHADAC tables. Attendees will also have the opportunity to hear more about CPS employer offer and take-up estimates, for which three full years of data will be available. Speakers will answer questions from attendees after the presentations. 

SHADAC Staff

p 612.624.4802
e shadac@umn.edu

NHIS: 2016 Uninsured Rates Stable, Disparities Persist

The National Center for Health Statistics (NCHS) has released the first early estimates of national uninsurance levels for 2016. Nationwide, the uninsurance rate among non-elderly Americans was 10.0% in the first quarter of 2016, which is statistically unchanged from 10.7% during the same period in 2015.

Overall Stability in Uninsurance

 The new estimates, which come from the National Health Interview Survey (NHIS), show that uninsurance rates were stable across age, race/ethnicity, and income groups from the first quarter of 2015 to the first quarter of 2016. This stability follows recent and historic declines in uninsurance from 2013 to 2014 and from 2014 to 2015.

Continuing Disparities

Despite the low national rate of uninsurance, disparities in uninsurance continue among certain subpopulations. In the first quarter of 2016:

• 18.0% of people in poverty were uninsured
• 14.9% of young adults(ages 19-25) were uninsured
• 18.6% of Hispanics were uninsured
• 12.4% of non-Hispanics who reported other races or multiple races were uninsured

Coverage disparities also exist between residents of states that expanded Medicaid and residents of states that did not: In the first quarter of 2016, the percent of non-elderly Americans without coverage was 13.6% in non-expansion states, compared to 7.9% in Medicaid expansion states.

	Uninsurance Rate:  Medicaid Expansion vs Non-Expansion States January to March, 2016

A Note about the Numbers

The above estimates provide a point-in-time measure of uninsurance, indicating the percent of persons without coverage at the time of the interview. Unless indicated, estimates represent rates of uninsurance for the non-elderly (ages 0-64). First quarter refers to January–March. Medicaid expansion states include: AK, AR, AZ, CA, CO, CT, DC, DE, HI, IA, IL, IN, KY, LA, MA, MD, MI, MN, MT, ND, NH, NJ, NM, NV, NY, OH, OR, PA, RI, VT, WA, and WV.

SHADAC Newsletter - September 2016

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