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Five Things To Take Away From The New Census Data On Health Insurance In America

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"Five Things To Take Away From The New Census Data On Health Insurance In America"

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The U.S. Census Bureau on Tuesday released its annual report on U.S. wages, poverty, and health demographics. The full 2012 report is available here and an accompanying assortment of charts may be found here.

While the Census data largely did not find statistically significant differences in American insurance statistics from 2011, it did highlight some areas of improvement — and several where the health care safety net still has a long way to go.

1. Millions of young Americans aged 19 to 25 are getting health insurance thanks to Obamacare.

In the U.S., the older you get as an adult, the more likely you are to have health coverage. Part of that is because younger people, while valuing health insurance, largely can’t afford it. Part of it has to do with the types of job opportunities (and the accompanying health benefits) that become available as you age. Public entitlement programs hold down uninsurance rates for most senior citizens and children.

The 2008 financial crisis and ensuing global recession led to a big rise in the numbers of uninsured young Americans, causing the uninsurance rate for 19 to 25-year-olds to surge from 29.3 percent to 31.4 percent between 2008 and 2009. But after Obamacare was passed in 2010, that percentage began falling and is now tied with the 26 to 34-year-old cohort for the second year in a row:

unisured by age

CREDIT: U.S. Census Bureau

This is largely due to the Obamacare provision that allows adults up to age 26 to remain on their parents’ health insurance. A Commonwealth Fund study from April found that the provision has extended health benefits to 3.4 million young Americans since 2010. This new-found insurance coverage ended up saving them $147 million in higher medical bills for expensive emergency room care that can’t be anticipated in advance, such as broken bones and accidental poisonings.

2. There are huge racial gaps when it comes to health coverage.

The Census figures show that if you’re black, you’re almost twice as likely to be uninsured than if you’re white. If you’re Hispanic, then you’re nearly three times as likely to lack health coverage compared to white Americans:

uninsured by race

CREDIT: U.S. Census Bureau

This is part of the reason that black Americans still die younger than white Americans despite a significant increase in African-Americans’ lifespans over the last several decades. Minority communities are exposed to public health dangers that are endemic to lower-income populations such as gun violence and food deserts, and have lower medical care quality even when they can afford it.

The even more significant disparity in Hispanic uninsurance rates is also a major reason that Obamacare is so important for Latinos and other Hispanics — and why red states’ ardent opposition to the health law’s Medicaid expansion could be extremely damaging for these populations. About 15 million of the 48 million uninsured Americans — a number that remained fairly steady in the most recent Census numbers — live in California, Texas, and Florida, and the vast majority of them are Hispanic. The latter two have refused to expand Medicaid under Obamacare, as have a slew of southern states like Mississippi and North Carolina where the Hispanic uninsurance rate is at a staggering 40 percent.

3. Being old or sick is really, really expensive — especially if you’re poor, but even if you have private insurance.

The topline poverty measure reported by the Census Bureau for 2012 stands unchanged from last year at 15.1 percent. But as many academics, journalists, and policymakers have pointed out, that’s a misleading number based on a highly outdated metric for measuring poverty that doesn’t incorporate things like rising health care costs, transportation, and housing. In fact, it literally bases the poverty threshold on how much a family of three in the early 1960s would have to earn in order to spend less than a third of their yearly income on food, adjusted for inflation (but nothing else).

Last year, the Census Bureau came up with a new metric called the Supplemental Poverty Metric that does take things like health care into account — and this year, it found that the actual poverty rate rises by an addition 3.4 percent when accounting for out-of-pocket medical costs:

poverty-components-spm

CREDIT: U.S. Census Bureau

Earlier research has shown that this disproportionately affects older Americans, likely due to the high costs of prescription drugs. In fact, when considering out-of-pocket medical spending, one in seven Americans seniors lives in poverty and at least twice the number of seniors are actually living in poverty in 12 states compared to what the official poverty metric would suggest.

The Census figures also reveal that median out-of-pocket medical spending in 2012 was 54 percent lower for someone with private insurance who is in good health compared to someone in fair or poor health. For uninsured Americans, median out-of-pocket medical spending was almost two and a half times as much for somebody in poor health, and the numbers were only marginally better for Americans with public health coverage.

That isn’t exactly surprising considering the largely arbitrary cost of U.S. medical procedures and lack of price transparency in the health care industry. This allows hospitals even within the same geographic regions to charge wildly different prices for various tests and services with no assurance of a corresponding change in the quality of the medical care that is provided.

4. Even if you’re a child, race, income level, and citizenship status determines if you have access to health care.

Over 60 percent of children who live in households making less than 200 percent of the Federal Poverty Level have health insurance through Medicaid. But the new data shows that 13 percent of these children are still uninsured — some in significantly greater numbers than others:

uninsured children

CREDIT: U.S. Census Bureau

Extending health coverage for Hispanic children is yet another reason that the Medicaid expansion is critical to reducing the chasm between the sickest and poorest states, especially considering the significantly higher incidence of chronic illnesses like diabetes among Hispanic populations. The staggering number of uninsured children who are non-citizens is further proof that comprehensive immigration reform is a prerequisite for addressing the high number of uninsured Hispanics.

5. Employers are seriously not cutting health benefits because of health reform.

Obamacare critics have been adamant about how employers would drop health benefits or roll back hours because of Obamacare despite abundant evidence to the contrary. The Census Bureau’s latest findings confirms earlier studies, finding that employers actually added 1.5 million workers to health insurance plans in 2012.

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