New U.S. Census statistics show uninsured rates rose from the previous year for the first time since the Great Recession.
FLORIDA — The number of people without health insurance increased from the previous year for the first time since the Great Recession, according to new figures released Tuesday by the U.S. Census Bureau.
“The poverty rate went down, the economy is doing well, and yet we’re still seeing more people
uninsured,” said Laura Skopec, a senior researcher for the nonprofit Urban Institute’s Health Policy Center.
In 2018, 27.5 million people, or 8.5% of the population, did not have coverage at any time during the year.
That’s 1.9 million people more than in 2017, when 7.9% did not have health insurance. The last time the United States saw a yearly increase large enough to be statistically significant was 2009, the final months of the Great Recession.
In Florida, the rate of people without coverage was 13%. That ranks it fourth in the nation.
Texas leads with nearly 18% of residents uninsured. Massachusetts had the fewest uninsured residents at less than 3%.
Most states did not see a significant shift in coverage rates. Those with increased health insurance rates saw changes of just less than 1 percentage point. Only three states saw uninsured rates drop more than the survey’s margin of error: Wyoming, South Carolina and New York.
“You don’t see a strong pattern in terms of which states are increasing and which are decreasing
coverage,” Skopec said of the new data. “There are three bright spots, but everybody else is either losing coverage or just maintaining.”
According to PanCare of Florida, a Panama City-based nonprofit that operates health care centers that serve Medicaid, Medicare and uninsured patients on a sliding payscale in 10 counties, it has seen a rise in uninsured patients in recent years.
According to the data, PanCare had 26,479 encounters with uninsured patients at its clinics in 2018. As of Sept. 10, the centers have already had 32,202 encounters with uninsured patients this year.
And in PanCare’s Panama City center, the facility has had 8,299 uninsured patient encounters as of Sept. 10, up from the 6,707 encounters it had all of last year.
Sean Golder, regional manager for PanCare, said the nonprofit recently extended operational hours at its Panama City clinic to treat more patients.
“The clinic is now open seven days a week,” Golder said. “What we’re seeing is more and more patients.”
Golder noted that the clinic opened a pharmacy last week to provide more services for the growing number of patients.
“That’s another access point for the uninsured,” Golder said.
Although fewer Americans had public health coverage in 2018 — mostly due to a drop in Medicaid recipients — the number of people with private insurance was largely the same.
It could be, at least in part, that some Americans who lost Medicaid coverage did not replace it with private insurance.
“Some portion of it is mechanical,” Skopec said. “As they get more income, they no longer qualify for Medicaid. When they fall off Medicaid rolls, they don’t get employer coverage or insurance through the marketplaces and they end up uninsured.”
Skopec also pointed to Census data that showed a growing number of middle-income families without coverage. For instance, families of four earning more than $102,000 a year saw the uninsured rate increase, and it did so almost three times more in states without Medicaid expansion.
She said this could be because families who do not qualify for Medicaid and who make too much money to receive a federal subsidy from the marketplace must pay their full premium — and premiums are on the rise nationwide.
“The highly subsidized people are shielded from premium increases,” she said. “But for this group, the 20% premium increase is all on you.”.
About two thirds of people surveyed had private health insurance, which most often is provided as a job benefit. But Skopec notes that the likelihood of an employer offering insurance varies widely by state and industry, which can leave some people in a gap where they do not qualify for public assistance but cannot afford to directly purchase coverage on their own.
Since 2014, states have had the option to expand Medicaid to more people, in part to close that gap.
Traditionally, the program provided coverage only to low-income parents and people with a disability, not low-income adults without children.
The data reinforced previous findings that states which expanded Medicaid programs to cover more low-income residents have fewer people without insurance and have shrunk the size of that group faster.
The 31 states with expanded Medicaid saw uninsured rates cut nearly in half from 12.6% in 2013 to 6.7% in 2018. The 19 states that have not expanded Medicaid saw their uninsured rates drop only half as quickly, going from 14.7% in 2013 to 10.6% in 2018.
States that have not expanded Medicaid, on average, have seen uninsured rates decline 28% from 2013 to 2018. Florida’s uninsured rate fell faster than most non-expansion states — 35% — but still has not fallen as quickly as expansion states, which averaged 47%.
“Health insurance coverage is an important measure of our nation’s overall wellbeing,” Sharon Stern, assistant division chief at the U.S. Census Bureau, said in a recorded presentation of the new data on Tuesday. “Whether it’s illness, injury, or preventative needs, health insurance provides greater access to medical care, protection from high unexpected costs and more economic stability.”