How Many Americans Have Health Insurance in 2023?
How Many Americans Have Health Insurance
Health insurance coverage has been a hot topic in American politics and discourse for decades. Having health insurance is crucial for gaining access to healthcare, managing chronic conditions, and avoiding financial hardship from medical bills. But how many people in the United States actually have health insurance?
In this comprehensive guide, we will analyze the latest statistics and survey data to determine how many Americans have health insurance in 2023. Unique, descriptive titles and headings help organize the information logically as we write clearly and authoritatively, linking to official government sources.
Highlights:
- 91.8% of Americans have health insurance as of 2022 surveys
- 30.2 million Americans remain uninsured as of August 2022
- Uninsured rates dropped nearly 5 percentage points since the Affordable Care Act expanded access
- Medicaid expansion under the ACA covered over 12 million more people
- Job-based health plans still cover over half the U.S. population
- Cost and unemployment remain leading barriers to getting health insurance
Jump to:
How Many Americans Have Health Insurance Coverage?
Who Are the Uninsured in the U.S.?
Why Do Millions Lack Health Insurance?
What Percentage of Americans Have Employer-Sponsored Insurance?
How Did the Affordable Care Act Impact Insurance Rates?
How Many Americans Have Health Insurance?
How Many People Are Covered by Medicaid and Medicare?
What Is the Best Way to Get Health Insurance?
FAQs About American Health Insurance Coverage
How Many Americans Have Health Insurance Coverage?
Recent surveys and estimates from the CDC show that as of 2022, approximately 91.8% of Americans have some form of health insurance. This means only around 8.2% of the population, or 27 million people, are currently uninsured.
This uninsured rate has dropped nearly 5 percentage points since the Affordable Care Act (ACA) health insurance marketplaces and Medicaid expansion went into full effect in 2014. Over that time period, nearly 23 million more non-elderly Americans gained health coverage.
According to the latest National Health Interview Survey (NHIS) data, here is the percentage breakdown of Americans with health insurance by type of coverage:
- Job-based plans: 54.7% of Americans
- Medicaid: 23.1%
- Medicare: 17.8%
- Direct-purchase plans: 16.9%
- Military health care: 4.5%
Source: CDC/NCHS National Health Interview Survey 2022
With over 90% insured rate and steady declines in the uninsured each year, America has made significant progress in expanding access to healthcare coverage over the last decade. But affordability issues, eligibility restrictions, and coverage gaps leave tens of millions still uninsured each year.
Who Are the Uninsured in the U.S.?
Despite historic coverage gains, 30.2 million Americans under age 65 remain uninsured as of August 2022 estimates. This means the non-elderly uninsured rate is approximately 12.0 percent.
Certain segments of the population have substantially higher uninsured rates than the national average:
- Hispanics: 17.7% uninsured
- Low-income households: 21.9% of those earning less than $25,000
- Young adults 19-34 years old: 14.4% uninsured
- Southern states like Texas, Oklahoma, Georgia, Florida, North Carolina and South Carolina which did not expand Medicaid have uninsured rates 50-100% higher than expansion states
Additionally, undocumented immigrants are ineligible for Medicaid, Medicare and ACA marketplace plans, leaving nearly half without coverage.
Why Do Millions Lack Health Insurance?
While the ACA made significant progress, millions remain uninsured due to eligibility restrictions and ongoing affordability issues:
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Medicaid Coverage Gap in Non-Expansion States
Over 2 million uninsured adults fall into the “coverage gap” because they earn too much for Medicaid but not enough for subsidies on the ACA marketplaces. To qualify for subsidies, income must be at least 100% of the federal poverty level.
But in the 12 states that have not expanded Medicaid eligibility, that threshold to qualify remains under 100% FPL. Hence those earning between approximately 75%-100% FPL have no affordable options for health coverage.
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High Cost of Plans and Out-of-Pocket Spending
In 2020, the average annual premium for an individual ACA health plan was $7,470. Deductibles on marketplace silver plans averaged $4,364. After premium contributions and cost-sharing, total potential spending reached almost $12,000. These costs place heavy burdens on working class families.
Even middle-class shoppers struggle to fit expensive health insurance premiums into tight household budgets. And out-of-pocket costs prevent insured people from actually using their health coverage to seek care. Surveys show 25% of insured adults still face difficulties or delays getting healthcare due to high out-of-pocket costs.
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Limited Awareness of ACA Subsidies
77% of the 30+ million uninsured are eligible for fully or partially subsidized ACA plans. But polls show only 39% of uninsured adults are familiar with subsidies. These widespread misconceptions leave struggling families unaware of coverage options. More education and outreach are sorely needed.
What Percentage of Americans Have Employer-Sponsored Insurance?
Despite rising premiums, job-based health plans remain the predominant source of coverage for Americans. Approximately 157 million people in the U.S. have health insurance through an employer. This represents about 54.7% of the non-elderly population as of 2022.
Employer coverage rates did decline about 7 percentage points since their peak in 2000. This drop was mainly driven by rising premiums pricing out small businesses. However, the vast majority of uninsured former employees have shifted over to the individual insurance market or public health programs.
How Did the Affordable Care Act Impact Insurance Rates?
In 2010 when the ACA was signed into law, nearly 50 million non-elderly Americans lacked health insurance. The uninsured rate at that time topped 18%.
By expanding Medicaid eligibility and offering income-based subsidies on individual market plans, the ACA’s two major mechanisms cut this rate down significantly within a few short years after full implementation.
Here is how key ACA coverage provisions impacted uninsured rates since 2010 national survey data:
- Allowing young adults up to age 26 to stay on a parent’s plan covered 3.6 million more young Americans. Uninsured rate for 19-25 year olds dropped over 10 percentage points.
- Opening Medicaid up to nearly all adults with incomes up to 138% of poverty level was originally intended to be national. But 2012 Supreme Court ruling allowed states to opt out. In the 38 states plus Washington D.C. that have expanded eligibility, over 12 million newly qualified and enrolled in Medicaid or CHIP. These Medicaid expansion states cut uninsured rates by over 45%.
- In the 12 states that have yet to expand Medicaid under the ACA, eligibility remains extremely restrictive. Uninsured rates in holdout states like Texas (18%) and Mississippi (14%) are about double the uninsured rate in high expansion states like Massachusetts (4%) and Connecticut (6%).
- ACA premium subsidies for private individual plans are available to all households between 100-400% of poverty level. Over 9 million people receive subsidies on ACA marketplace plans, with average monthly assistance around $521 per subsidized enrollee. The uninsured rate among marketplace-eligible shoppers fell by over 7 percentage points. Subsidies make these plans affordable for most low- to middle-income applicants.
Overall, national uninsured rates have declined between 40-45% from peak levels in 2010. While barriers to accessing care still impact far too many families, the vast majority of Americans are now covered.
How Many People Are Covered by Medicaid and Medicare?
Medicaid and Medicare are crucial public health insurance programs covering low-income families, people with disabilities, vulnerable elderly adults and more. Together, they insure over 40% of Americans.
Medicaid and CHIP provide free or low-cost health coverage to 76 million low-income adults, children, pregnant women, elderly adults and people with disabilities. The programs are run by states but jointly funded by federal and state governments. Anyone meeting certain income and other eligibility rules can sign up.
All states have expanded Medicaid to cover children; pregnant mothers up to at least 133% of poverty level. ACA provisions allow states to open eligibility up to 138% of poverty for all qualifying adults. And coverage is mandatory for Supplemental Security Income (SSI) recipients with incomes up to 74% of poverty.
Medicare covers over 63 million people over age 65 and younger adults receiving Social Security Disability benefits. Part A Hospital coverage is free for most beneficiaries. Part B Medical coverage has monthly premiums starting from $164 up to $504 for higher earners. Part D Prescription Drug plans and Medicare Advantage plans are also available for purchase and tells How Many Americans Have Health Insurance
What Is the Best Way to Get Health Insurance?
If you’re worried about getting or keeping health coverage, here are some top options to consider:
- Check if You Qualify for Medicaid Income limits vary widely for Medicaid and CHIP based on categories like age, pregnancy status, disabilities and state of residence. Use this eligibility calculator to see if you may qualify in your region.
- See if You Can Get ACA Subsidies Even middle income families earning $100,000+ can qualify for some level of premium subsidies on healthcare.gov plans. Use this subsidy calculator to determine potential tax credits and premium estimates. During open enrollment each fall, compare health plan options in the online marketplace. Outside of open enrollment, only those who qualify due to certain life events can sign up.
- Explore Small Business Health Insurance Options For the self-employed and very small companies, group coverage was often unattainable in the past. Now enhanced under the ACA, Small Business Health Options (SHOP) exchanges match companies up to affordable group plan options. Fees differ widely based on your company size, employee ages, health status and benefits selected. So get free personalized quotes to find the most competitive rates from reputable providers.
The ACA has made finding affordable health insurance coverage possible for nearly all Americans regardless of preexisting conditions. Evaluate all your options to determine the plan type that best fits your budget and medical needs. Reach out for personalized assistance from independent licensed health coverage agents at Healthcare.gov if you still have questions. Rest assured nearly everyone who needs help paying for healthcare has options in 2023!
FAQs About American Health Insurance Coverage
Here are answers to some additional top questions our readers ask about health insurance rates and statistics in the United States:
How many uninsured children are there?
- Out of over 73 million children under 18 in the U.S., only about 5% or 3.6 million remain uninsured. Thanks to CHIP and Medicaid expansions, as well as ACA reforms, children have much higher insured rates on average.
Which is bigger, Medicaid or Medicare?
- Medicaid currently covers significantly more people (over 76 million) compared to Medicare’s 63 million enrollees. But in terms of spending, Medicare’s costs per capita are nearly double Medicaid.
What percent of Americans get health insurance through work?
- Over half of Americans (157 million people, or 54.7% of the under-65 population) have job-based group health insurance plans. Despite rising costs and reductions, employer plans still dominate the health coverage market due to ease of access and tax advantages.
Conclusion
How Many Americans Have Health Insurance-Gaining health insurance remains crucial for access to healthcare and financial stability for nearly all Americans. Fortunately over 90% now have coverage, thanks to expansions under Medicaid, Medicare and the ACA marketplaces.
But issues around affordability and restricted access in states that limit Medicaid eligibility leave over 27 million under 65 still uninsured. Ongoing reforms aim to chip away at that number through more affordable premiums, reduced cost-sharing burdens and expanding state Medicaid programs.
Centering our fragmented healthcare system around human need remains an ongoing challenge. But survey data and estimates make clear America has made substantial progress covering millions more people compared to just a decade ago. It is incumbent on politicians and the healthcare industry to continue this trajectory until everyone can access the quality, affordable healthcare that underpins human dignity, productivity and wellbeing.