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40 Eye-Opening Health Insurance Statistics You Need to Know

Health Insurance Statistics - Featured Image

America has the most confusing health insurance in the world: a dysfunctional mix of Medicaid, Medicare, employer-paid private plans, and various specialized programs. Despite all these options, at the beginning of 2020 more than 30 million Americans didn’t have any health insurance at all.

Health insurance statistics show that the coronavirus pandemic drove that number even higher. America spends more than most countries’ annual GDP on healthcare. Why are there so many uninsured people? Why is the system so bad?

Editor’s Choice

  • 30.9 million Americans didn’t have any type of health insurance in the first half of 2019.
  • The COVID-19 pandemic cost 27 million Americans their health insurance in its first months.
  • Large companies that fail to provide health insurance to 95% of their full-time employees must pay an IRS fine of $3,860 per employee per year.
  • 3 out of 4 Americans think that healthcare is too expensive compared to the services they receive, health insurance statistics say.
  • When the Affordable Care Act’s major provisions went into effect in 2014, the number of uninsured Americans dropped by 35.9% in a single year.
  • 45% of Americans worry that medical costs will lead them to personal bankruptcy.

Health Insurance Statistics - Featured Image 2

General Statistics

Most Americans get their insurance from three programs: Medicare, Medicaid, and employer-provided private insurance. Medicare insures people over the age of 65. Medicaid and the Children’s Health Insurance Program insure the poor and the unemployed. Employer-provided private health insurance covers employees and their families.

Health insurance statistics show that together, these programs cover about 275 million Americans. Of the remaining 55 million, 24 million are covered by small specialized programs, leaving about 31 million uninsured Americans responsible for paying their own healthcare costs.

Most people get health insurance through their employers. If you work for a large corporation, you’ll most likely be covered because the government gives tax benefits to companies that insure their workers and penalizes those that don’t.

If you work for a company that has fewer than 50 employees, you are self-employed, or you work part-time, you are in trouble. The company is not required to pay your health insurance.

With employer-based coverage, losing your job means losing your health insurance.

1. About 91.5% of Americans are covered by health insurance, according to health insurance statistics.

(US Census Bureau)

2. Of 330 million Americans, 59 million get Medicare, 159 million have employer-based insurance, and Medicaid/CHIP covers 57 million.

(Congressional Budget Office)

3. About 22 million people get insurance through provisions of Obamacare.

(Congressional Budget Office)

Another 8 million Americans get medical insurance through Medicare disability coverage, and 8 million have other insurance.

4. Employees don’t pay taxes on the amount of money their companies pay for their health insurance.

(Tax Policy Center)

This policy – the tax exclusion for employer-sponsored health insurance – cost the federal government $273 billion in reduced taxes in 2019.

5. Health insurance statistics show that 5.4 million US workers lost their health insurance in the first half of the year due to pandemic.

(New York Times)

6. Large companies that fail to provide health insurance to 95% of full-time employees must pay an IRS fine of $3,860 per employee per year.

(Society for Human Resource Management)

7. On average, employers pay about 82% of the cost of their employees’ health insurance.

(Kaiser Family Foundation)

This percentage drops to 71% for employees who add family members to their coverage.

8. On average, monthly worker contributions for health insurance are $103 for single coverage and $501 for family coverage.

(Kaiser Family Foundation)

That’s $1,242 annually for single coverage, and $6,015 annually for family coverage.

9. The average annual premiums for employer-sponsored health insurance are $7,188 for single and $20,576 for family coverage.

(Kaiser Family Foundation)

10. The US spends 16.9% of GDP on healthcare – twice as much as the average OECD member country.

(Organisation for Economic Co-operation and Development)

11. The US spent $3.6 trillion on healthcare in 2018.

(US Centers for Medicare and Medicaid Services)

12. 3 out of 4 Americans think healthcare is too expensive compared to the services they receive.

(Gallup)

13. Health insurance facts show that Americans pay $1,122 out-of-pocket for different medical expenses like co-pays and prescriptions.

(Organisation for Economic Co-operation and Development)

14. Health insurance facts show that Americans pay $1,122 out-of-pocket for different medical expenses like co-pays and prescriptions.

(Organisation for Economic Co-operation and Development)

About the Uninsured

People who don’t have insurance in America are typically the unemployed and self-employed, gig workers, part-time workers, and those who work for smaller companies that don’t provide health insurance as an employment benefit. These people simply don’t have a lot of options. If they are unable to pay for health insurance, there aren’t that many government programs that can help.

Based on American healthcare system facts, the only way to become eligible for Medicaid is to be disabled or below the poverty line. This means that millions of people with low-paying jobs, working for small companies, don’t receive government-funded healthcare. Since health insurance premiums are expensive, many families are simply left without options.

The most jeopardized groups are Hispanics and African Americans, health insurance statistics reveal. However, ethnic and racial groups are not the only ones affected by gaps in healthcare coverage.

Health insurance data shows that young people, especially millennials, are not covered by any of America’s health insurance plans. Children are also a vulnerable group when it comes to health insurance, while people over 65 are the most covered group thanks to Medicare assistance.

Healthcare facts and statistics reveal that healthcare coverage varies by state and even by county. The Southern states, including Texas and Oklahoma, have the highest uninsured rates.

15. 30.9 million Americans didn’t have any type of health insurance in the first half of 2019.

(Centers for Disease Control)

16. America’s uninsured population increased by 1.9 million from 2017 to 2018, largely because many Americans no longer qualified for Medicaid.

(US Census Bureau)

17. The COVID-19 pandemic cost 27 million Americans their health insurance in its first months.

(Kaiser Family Foundation)

Among them are 10.1 million workers who lost both their jobs and their families.

18. US health insurance industry statistics show that the average price for COBRA health insurance is $599 / month for individual coverage, and $1,715 / month for family coverage.

(Kaiser Family Foundation)

COBRA is intended to provide temporary health insurance to people who lose their jobs or lose their company-paid insurance for other reasons.

19. More than 26,000 Americans die needlessly each year because they lack health insurance.

(Families USA)

People without insurance are likely to go without screenings, preventive care, and medications.

20. Companies with fewer than 50 employees are not legally required to provide health insurance benefits to employees.

(eHealth)

This is about half the companies in the US.

21. Gig workers and part-time employees aren’t generally covered by employer-provided health insurance.

(Employment Law Handbook)

Gig workers are not considered employees, and companies are not legally required to provide health benefits to those who work 30 hours or less per week.

22. 99.1% of Americans 65 and older have health insurance.

(US Census Bureau)

This group is followed by young adults and children under 19 (94.5%). Only 88.3% of people between 19 and 64 have medical insurance.

23. About 30% of people between 19 and 25 don’t have health insurance, followed by 13.9% of those aged 26 to 34.

(Centers for Disease Control)

24. Besides young adults, children under the age of 19 are the most likely to be uninsured.

(US Census Bureau)

The percentage of uninsured children was 22.8% in 2018.

25. 27% of Hispanic people were uninsured in the first half of 2019, followed by African Americans (13.6%), according to healthcare statistics in the US.

(Kaiser Family Foundation)

26. For people under 65, the uninsured rate increased in 80 US counties and decreased in 70 counties from 2017 to 2018.

(US Census Bureau)

27. Counties with the lowest uninsured rates (below 10%) are in the North and Midwest.

(US Census Bureau)

On the other hand, the southern states have counties with uninsured rates above 15.9%.

28. Texas has the highest uninsured rate: 17.7%, followed by Oklahoma (14.2%), health insurance statistics by state reveal.

(US Census Bureau)

Politics and Health Insurance

You don’t need to see US health insurance statistics to know that public health insurance is a highly politicized subject. Political parties keep arguing about how to allocate funds for health insurance programs and whether people should even have access to government-paid programs.

The Obama administration worked with Congress to create the Affordable Care Act – Obamacare – which became law in 2010. The ACA was a compromise between universal healthcare and the existing free-market system.

It was envisioned as an expansion of employer-paid private insurance to cover uninsured Americans as if the US government were their employer. The program was administered through Medicaid. According to Obamacare statistics, when the ACA’s major provisions took effect in 2014, the number of uninsured people dropped by 35.9% in a single year.

Health Insurance Statistics - Featured Image 3Donald Trump became president in January of 2017 and vowed to dismantle Obamacare, which he considered both too expensive and harmful to the American healthcare system.

For example, federal attorneys went to court to argue that the individual mandate, which required that everyone participate in the country’s universal healthcare program, was unconstitutional. The court upheld the mandate, but it has been reduced to $0 per year, and the Trump administration has eliminated the penalty for not enrolling.

Congress failed by a single vote to repeal the ACA, but Republicans have worked to weaken the law bit by bit. Some provisions, like keeping adult children on their parents’ insurance policies until they are 26 years old, enjoy wide bipartisan support. Others, like federal subsidies for states to offer Medicaid benefits to more Americans, remain a matter of great political controversy.

It is the Affordable Care act that requires employers with more than 50 workers to provide health insurance to employees. Employers must provide health insurance to at least 95% of their full-time employees or pay a $3,860 per employee per year penalty to the IRS.

Health insurance statistics show that the number of uninsured Americans dropped following the ACA’s enactment and began rising again once President Donald Trump took office.

29. When the ACA’s major provisions took effect in 2014, the number of uninsured people dropped by 35.9% in a single year.

(Kaiser Family Foundation)

30. Between 2010 to 2015, more than 16 million people got health insurance thanks to the ACA.

(US Department of Health & Human Services)

31. Between 2014 and 2015, the number of uninsured young adults dropped by 5% thanks to ACA.

(US Census Bureau)

32. Health insurance facts show that 8.5 million people signed up for ACA insurance in 2019.

(US Centers for Medicare and Medicaid Services)

33. Obamacare was projected to reduce the number of uninsured Americans by 25 million by the end of 2023.

(Congressional Budget Office)

34. The number of uninsured people in the US is expected to grow by 13 million in 2027 alone

(Congressional Budget Office)

The Congressional Budget Office bases this prediction on the fact that the ACA individual mandate will be eliminated.

35. In 2018’s congressional midterm elections, 45.9% of television ads for House and Senate races raised the issue of health insurance.

(Wesleyan Media Project)

As much as 54.5% of ads supporting Democrats brought up this subject and 31.5% of ads supporting Republicans.

36. Healthcare in the United States facts show that 48% of Americans think the US health system is the best or among the best in the world.

(Gallup)

The rate is higher among Republicans (67%), while only 28% of self-identified Democrats believe this.

Predictions

No one knows what tomorrow will bring, but America’s health insurance problems do not seem to be speeding toward a happy resolution. Statistics reveal how many Americans have health insurance, which groups are not covered, and how much patients must pay to visit the doctor.

Health insurance rates by year reveal a growing uninsured population – and that’s without counting the COVID-19 pandemic, which has separated millions of people from their paychecks and employer-paid health insurance.

37. 45% of Americans worry that a major health issue will lead them to personal bankruptcy.

(Gallup)

38. CBO estimates for 2029 show 159 million Americans receiving full coverage health insurance from employers.

(Congressional Budget Office)

Another 85 million will be enrolled in Medicare, and 71 million on Medicaid/CHIP according to CBO’s predictions. About 35 million Americans will not have any type of insurance. The CBO published these forecasts in May 2019, so they do not include the effects of the coronavirus pandemic.

39. America’s overall healthcare costs are projected to grow from $7.72 trillion in 2017 to $10.06 trillion by 2022.

(Deloitte)

40. Estimates on how many people will ultimately lose their jobs to the pandemic range up to 50 million or more.

(Forbes)

Each one represents another American or American family losing access to affordable private health insurance.

FAQ

How many people have health insurance in the US?

91.5% of Americans – about 302 million – are covered by health insurance. American healthcare system facts reveal that Americans are not equally covered. The number of insured people varies based on age, race, ethnicity, income, region, and other factors.

How many Americans die from lack of insurance?

Families USA estimates that more than 26,000 Americans die each year due to the lack of health insurance, largely because they don’t seek medical care until they are sick. Preventive care, screenings, and medication could reduce that number.

What percentage of the population has private health insurance?

62.1% of Americans have private health insurance, the latest health insurance statistics reveal.

What does health insurance cover?

Health insurance varies from insurer to insurer and policy to policy. While virtually all policies include emergency treatment and some hospitalization, they differ greatly when it comes to prescriptions, limits, deductibles, and covered treatments.

If you have a health crisis that is not covered by your insurance policy, you could find yourself with serious financial problems. According to health insurance statistics, medical debt is the cause of 18% to 26% of American personal bankruptcies. And that’s with 91.5% of people insured.

Sources

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