What to Look for in Next Week’s Census Figures on Poverty, Income, and Health Insurance

1. Progress on Health Coverage Likely Ended and May Have Partly Reversed
Census will issue national and state estimates of health insurance coverage for 2017, based on its Current Population Survey (CPS) and American Community Survey (ACS). The 2017 figures will likely mark a break from recent trends, which showed historic coverage gains after the Affordable Care Act’s (ACA) major coverage expansions took full effect in 2014.

The share of Americans without health insurance dropped from 13.3 percent in 2013 to 8.8 percent in 2016, falling in every year and for virtually every racial, ethnic, gender, education, and income group that the Census data cover.Some 13.7 million fewer Americans were uninsured in 2016 than 2013. Although technical changes in the CPS survey questions hamper comparisons with years before 2013, CPS and other survey data also show substantial declines in uninsurance from 2010 to 2013 as earlier ACA provisions took hold.

Health coverage gains were greatest in the 31 states (including the District of Columbia) that extended Medicaid to more low-income adults by January 2016 under the ACA’s Medicaid expansion. If the uninsured rate had fallen in non-expansion states as much since 2013 as it did in expansion states, 4 million fewer Americans would have been uninsured in 2016.

The Census data released on September 12, 2018 are expected to show an end to — and possibly a reversal of — these positive coverage trends, with the uninsured rate remaining steady or rising slightly in 2017 from its historic low of 8.8 percent in 2016. Data from the smaller, previously released National Health Interview Survey (NHIS), which typically aligns with the Census data, show that the overall uninsured rate remained statistically unchanged in 2017.

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