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Blog & News
MEPS-IC State-Level ESI Trends, 2013-2014
March 17, 2016:Employer Health Insurance Mostly Stable in First Year Post-ACA, but Some States Show Increased Take-up, Decreased Offer
The Agency for Healthcare Research and Quality (AHRQ) recently released its first state estimates of post-ACA employer-sponsored health insurance (ESI) from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC). In this blog, we examine 2014 state estimates of ESI offer, eligibility and take-up, showing changes since 2013 that are statistically significant at the 95 percent confidence level.
While national data show statistically significant changes in worker offer, eligibility, take-up and total average premiums between 2013 and 2014, there were not significant changes in most states. However, those states that did see statistically significant changes largely mirrored the national trends. The following are highlights from the new data.
Ten states saw increases in workers opting to enroll in health insurance (Figure 1).
Consistent with the national trend, 10 states experienced significant increases in the percentage of workers choosing to enroll in health insurance (known as coverage “take-up”) when their employers offered it to them, while only Maine experienced a significant decline in take-up. The national-level increase in take-up is a change from the decline in take-up that had occurred for more than a decade.
Note: Estimates represent enrollment in health insurance by workers eligible for coverage, if their employers offer employer coverage.
Four states experienced decreases in the percent of workers eligible for employer-based coverage (Figure 2).
Four states experienced significant declines in the percentage of workers eligible for health insurance in businesses that offer coverage, while none saw significant increases. The decline in these four states is consistent with a national decline in eligibility from 2013 to 2014. The national-level decline is a change from the previous two years, during which national levels were statistically stable.
Note: Estimates represent eligibility for health insurance, if their employers offer coverage.
Nine states saw premium increases for single coverage, and 11 saw increases in family coverage (Figure 3).
Nationally, average annual premiums increased significantly for both single and family coverage, a trend also found in several states. Average annual premiums for single coverage increased significantly in nine states, ranging from 6.5 percent in Texas to 12.5 percent in Kentucky. Premiums for family coverage also increased significantly in 11 states, ranging from 5.7 percent in Texas to 11.0 percent in Washington. Nationally, premiums increased 4.7 percent for single coverage and 3.9 percent for family coverage.
Seven states experienced decreases in the percent of workers employed in businesses that offered coverage (Figure 4).
The percentage of workers in businesses that offered coverage decreased significantly between 2013 and 2014 in seven states, and it increased in one state (Colorado) from 80.9% to 84.7%. This is consistent with national trend, in which the percentage of workers employed in firms offering coverage has declined for the past several years, including from 2013 to 2014.
Further Reading: AHRQ Chartbook with Longer-Term ESI Trends since 2003
In addition to releasing 2014 MEPS-IC state estimates, AHRQ also has published a chartbook that looks at longer-term trends in ESI since 2003, including offer, eligibility and take-up; premiums, with employer and employee contributions; and cost sharing. The chartbook is available here.
Blog & News
Now Available: 2014 Detailed State and County Level Coverage Estimates from SHADAC
October 8, 2015:Using the new detail level data available from the American Community Survey (ACS), SHADAC has produced state and county level tables and state-level maps on coverage that are available here. This blog provides an overview of the type of information that is available in the state profiles.
Uninsured Rates by Characteristic for Each State
For each of the 50 states, D.C. and Puerto Rico, SHADAC has produced a 2-page profile that includes uninsured rates by characteristics including:
- Age
- Race
- Citizenship status
- Education
- Work experience
- Income
By accessing these tables, you can get information about the number and percent of uninsured within specific population segments. For example, the table below shows that in Alabama 14.3% of blacks were uninsured in 2014, a drop from 16.7% in 2013.
In addition, the state profiles contain a comparison of 2013 and 2014 uninsurance rates for large counties in the state (e.g. counties with a population greater than 65,000). For example, the table below shows that in Hartford County Connecticut 5.5% of all people and 2.3% of children were uninsured in 2014, a drop from 8.6% and 3.7% in 2013, respectively.
Publication
Coverage Gains After the Affordable Care Act Among the Uninsured in Minnesota
Call, K.T., Lukanen, E., Spencer, D., Alarcon, G., Kemmick Pintor, J., Baines Simon, A., & Gildemeister, S. (2015). "Coverage Gains After the Affordable Care Act Among the Uninsured in Minnesota." American Journal of Public Health 105(S5): S658-S664. doi: 10.2105/AJPH.2015.302837
Publication
The Enrollment Rodeo: Who's Galloped In, and Who Will Be Lassoed Next?
Presentation by SHADAC Deputy Director Elizabeth Lukanen at the 2015 Annual Conference of the National Association of State Health Policymakers (NASHP), in Dallas, TX, on October 21, 2015.
Publication
2014 ACS Tables: State & County Uninsurance Estimates
The map on this page links to tables containing state and county uninsurance estimates for 2014. These estimates come from the 2014 American Community Survey (ACS) via the U.S. Census Bureau’s American FactFinder (AFF) tool and were released on September 17, 2015. 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 2014 and comparison year 2013.
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.
Additional Estimates (50-State Comparisons)
Maps & Tables of Private, Public, & Uninsured Change from 2013 to 2014
- Private Coverage Rates by State, Change from 2013 to 2014, for All People
- Public Coverage Rates by State, Change from 2013 to 2014, for All People
- Uninsurance Rates by State, Change from 2013 to 2014, for All People
- Uninsurance Rates by State, Change from 2013 to 2014, for Children under Age 18
Uninsured Trends from 2011 to 2014
- Uninsurance Rates by State from 2011-2014, for All People
- Uninsurance Rates by State from 2011-2014, for Children under Age 18
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. County estimates are available for all counties below this population threshold using the five-year (i.e., 2010-2014) ACS estimates.
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.
