Useful resource on uninsured numbers

statehealthfacts.org is a useful resource for providing context to the Medicaid expansion decision facing states. statehealthfacts.org is a project of the Kaiser Family Foundation, which for my money is the best source of objective health care/reform data around. A few of the ‘stylized facts’ on the uninsured population under the poverty level that states could cover them via Medicaid that you can get from statehealthfactors.org.

These are national averages highlighted above, but the links show these rates of being uninsured by poverty status for each state (and many of cross tabs). The rate of uninsurance is lower for kids because of expanded coverage via Medicaid for children that states have already undertaken. The differences in the two rates of uninsurance show that many of those who would be covered by the ACA Medicaid expansions will be adults, and mostly childless adults.

This September 2011 Kaiser Family Foundation document puts the number of elderly persons (age 65+) in the U.S. who are uninsured at around 792,000 in 2011 (~2% uninsured rate; 800k/~41M). Such persons would include those without sufficient standing in Social Security/Medicare (didn’t pay in enough quarters of the Medicare payroll tax), as well as people who immigrated to the U.S. at older ages following welfare reform, and a smaller number of persons who can be exempt from Medicare and Social Security (ministers/pastors/clergy).

Not to belabor the horribly obvious, but if you just provided insurance for folks you can just about do away with the uninsured problem (Medicare). If you expand Medicaid you can greatly reduce the problem, though there are still issues with people being eligible and not signing up. The ACA will provide subsidies to purchase private health insurance, with the uptake rate likely being related to how successful states are at marketing insurance exchanges and options to their population.

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

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