Health Insurance Coverage Reached Historic High in 2015
A Census data brief by the Applied Population Lab
Based on data just released by the US Census Bureau, the share of Americans who are covered by health insurance reached a never-before-seen high in 2015, both nationally and in Wisconsin. Over 90% of Americans now have health insurance coverage, up from 85.5% in 2013 and 88.3% in 2014. 2015 saw a statistically significant increase in health insurance coverage in all but three states (North Dakota, South Dakota, and Wyoming), compared to 2014.
Nearly 21 million more people are now covered by health insurance of some type, compared to the rate from 2013, before implementation of the Affordable Care Act. The Affordable Care Act, or "Obamacare", includes several provisions that were intended to get health insurance coverage to uninsured citizens. We have estimated that a large majority of this recent change in insurance status is attributable to Obamacare, and not other economic or demographic forces (such as population aging or employment change).
In Wisconsin, health insurance coverage went up to 94.3% in 2015. That’s up from 90.9% in 2013. Wisconsin once again ranks 7th among the states (tied with Rhode Island) for its overall rate of health insurance. Massachusetts, Vermont, the District of Columbia, Hawaii, Minnesota, and Iowa still outrank Wisconsin.
Health Insurance for Children
Although the ACA did not include provisions specifically aimed at improving coverage for children, the percent of children (ages 0-17) with health insurance in the United States rose from 94.0% in 2014 to 95.2% in 2015. 32 states had significant drops in the numbers of kids without health insurance between 2014 and 2015.
Wisconsin was among the states that saw statistically significant increases in health insurance among kids last year: 96.4% are now covered (compared to 95.6% in 2014, and 95.3% in 2013). This represents over 15,000 additional Wisconsin children with insurance coverage since the provisions of the Affordable Care Act (aka Obamacare) took effect.
Although Wisconsin has a relatively high rate of coverage for kids, the state has not stood out. Wisconsin had just a 1% increase in coverage for this age group, while other states had larger gains. Because other states had even bigger improvements in insurance among kids, Wisconsin dropped in rankings again. Wisconsin now ranks 19th (tied with Louisiana and Oregon) among the states for the rate of health insurance among children–down from 16th in 2014 and 14th in 2013. The state with the highest coverage for kids is Vermont, with 99%. The state with the biggest improvement in coverage for kids since Obamacare took effect on January 1, 2014, is Nevada, which went from 85.1% to 92.4% of kids covered in 2013-2015.
Insurance among the Working-Age Population
Many of Obamacare’s provisions target access to health insurance for working-aged people. This is because working-aged people are the most likely to have no insurance. There are more public programs available for children than for pre-retirement adults, and at age 65 most US citizens because eligible for public insurance (Medicare) for the first time.
Last year, health care coverage among working-aged adults (ages 18-64), went up significantly in 47 states and the District of Columbia (the exceptions, again, are North and South Dakota and Wyoming). The nation as a whole saw an increase in health insurance coverage from 83.7% (+/-0.1%) to 86.9% (+/-0.1%) in this age group. This continues the trend we reported in 2013-2014, when all 50 states and the District also had significant increases in insurance coverage among working-aged adults.
In Wisconsin, rates of health insurance coverage went up from 87.2% in 2013 to 89.9% in 2014, and then a large jump up last year to 92.3%–the highest rate since health insurance coverage has been assessed by the US Census Bureau.
Wisconsin ranks 7th in the nation for health insurance coverage once again. It had fallen to 9th in 2014.
Insurance by Income Level
Below 138% of the Federal Poverty Line
Insurance rates for people living below or near the poverty line increased nationally from 79.1% in 2014 to 82.8% in 2015, and Wisconsin was among the 40 states with statistically significant increases in health insurance coverage for this group. Wisconsin had a big increase in the share of people living below 138% of the Federal Poverty Line with some form of insurance for the second year in a row.
Between 138 and 200% of the Federal Poverty Line
Nationally, insured rates for lower income residents increased from 81.5% to 85.1%. Thirty-six states had significant increases in coverage in this group, including Wisconsin. Wisconsin’s rate of insurance for this group, sometimes referred to as the "near-poor", was 89.1% (up from 87.7% in 2014).
200% or more of the Federal Poverty Line
No state had a significant change in this category, but the national rate of health care coverage for the nonpoor went up to an historic high of 94.0%. Wisconsin achieved 96.4% health insurance coverage among the nonpoor.
Commentary
The central goal of the Affordable Care Act was to reduce the number of US residents without health insurance. 2015 was the first full year after the implementation of major aspects of the new law, including the individual requirement to have insurance, new rules and tools for individuals purchasing insurance plans, subsidies of individual insurance plans for qualifying people, and (in some states–but not Wisconsin) an extension to public health insurance for people living near the poverty line as well as those living below it. We are seeing clear effects of these policy changes in higher rates of health insurance–particularly among working-aged adults.
In 2015, Wisconsin retained its long-standing position as one of the best-covered states. Wisconsin improved health insurance coverage apace with the nation.
Methods Notes
Data are from the US Census American Community Survey 1-year estimates for 2009 - 2015 at the national and state levels. To calculate statistically significant changes from year to year, we assumed an alpha of 0.05. For rankings, when states were tied, we assigned both states the same (higher) value. Puerto Rico and other island territories were excluded from our analysis (but Washington, DC was retained).