Health Insurance Coverage: Who's Protected?

Health insurance coverage is provided by a mix of public and private sources in the United States, the sole industrialized nation without universal healthcare coverage. In 2022, nearly 304 million people in the US had some form of health insurance, up from around 257 million in 2010. However, over 25 million people in the US were still uninsured in 2022, with cost being the primary reason for a lack of coverage.

How many people are covered by employer-based insurance?

Employer-based health insurance is the largest source of health coverage for nonelderly people, and it plays a significant role in providing financial protection and access to healthcare services. In 2018, 58% of the nonelderly population, or approximately 156.5 million people, were covered by employer-based insurance. This number has fluctuated over the years, with a notable decline of 8 percentage points between 1998 and 2018.

The importance of employer-sponsored insurance has been decreasing over time, especially for lower- and moderate-income households. The COVID-19 pandemic and its economic fallout have also impacted access to employer-sponsored coverage, with rising unemployment leading to a potential short-lived nature of the modest gains in coverage seen in recent years.

In 2023, the average annual premium for employer-sponsored health insurance was $8,435 for single coverage and $23,968 for family coverage. On average, employees contribute about 17% of the premium for single coverage and 28-29% for family coverage. The specific contribution percentages depend on factors such as company size and the employee's wage group.

According to the Kaiser Family Foundation, in small businesses, 29% of employees have their entire premium for single coverage paid by the employer, while only 5% of employees in larger companies have this benefit. On the other hand, 31% of covered employees in small businesses contribute more than half of their premiums for family coverage, compared to 5% in larger companies.

While employer-based health insurance is a vital source of coverage for many, it is essential to note that not all workers are eligible for this benefit, and some may choose not to enrol due to factors such as affordability. Overall, employer-sponsored health insurance provides financial protection and access to healthcare for millions of people, but it is just one component of the complex healthcare landscape.

How many people are covered by non-employer-based insurance?

In the United States, health insurance coverage is provided by a combination of public and private sources. In 2019, the total US population was around 330 million, with 59 million people aged 65 and above covered by the federal Medicare programme. Of the 273 million non-institutionalised people under 65, 159 million had employer-based coverage, 84 million had non-employer-based coverage, and 30 million were uninsured.

The number of people with non-employer-based coverage in the US has fluctuated over time. In 2018, 84 million people under the age of 65 had non-employer-based insurance. This number decreased to 82 million in 2019 and then to 77 million in 2020. The latest data from 2021 shows that the number increased to 85 million.

The percentage of people with non-employer-based insurance has also varied. In 2018, it was 30.8% (84 million out of 273 million), and in 2019, it was 30.4% (82 million out of 269 million). The percentage decreased to 28.1% in 2020 (77 million out of 274 million) and then increased to 31.1% in 2021 (85 million out of 273 million).

While the numbers and percentages have fluctuated, a general trend can be observed. The number of people with non-employer-based insurance decreased from 2018 to 2020 and then increased in 2021. The percentage of people with non-employer-based insurance followed a similar pattern, with a decrease from 2018 to 2020 and an increase in 2021.

It is worth noting that the data provided is for the non-institutionalised population under the age of 65, as the federal Medicare programme covers those aged 65 and above. Additionally, the numbers and percentages may not always add up due to changes in the total population and rounding.

How many people are uninsured?

In 2022, 8.4% of Americans, or 27.6 million people, did not have health insurance. This is a decrease from 10.3% or 33.2 million in 2019. The number of uninsured Americans dropped by 5.6 million from 2019 to 2022.

Among working-age Americans (those aged 18–64), 12.2% did not have health insurance in 2022, a decrease from 14.7% in 2019. The uninsured rate among working-age adults aged 19 to 64 decreased by 0.8 percentage points to 10.8% between 2021 and 2022.

In 2023, the national uninsured rate reached an all-time low of 7.7%. Approximately 6.3 million people gained coverage since 2020, coinciding with the beginning of the Biden-Harris Administration.

In 2019, the US population was approximately 330 million, with 59 million people aged 65 and over covered by Medicare. The 273 million non-institutionalized persons under age 65 either obtained their coverage from employer-based (159 million) or non-employer-based (84 million) sources, or were uninsured (30 million). 89% of the non-institutionalized population had health insurance coverage.

The number of nonelderly uninsured individuals (under 65) continued a downward trend, dropping by nearly 1.9 million from 27.5 million in 2021 to 25.6 million in 2022. The uninsured rate decreased from 10.2% in 2021 to a record low of 9.6% in 2022.

How many people are covered by public vs private insurance?

In the United States, 92.1% of people, or 304 million, had health insurance in 2022, an increase from 2021 when 91.7% or 300.9 million were covered. Of those insured in 2022, 65.6% had private health insurance, while 36.1% had public coverage. This represents a slight decrease in public coverage from 2019, when 92% of the US population was covered by public or private health insurance.

Private health insurance coverage in the US is primarily gained through employment, with 54.5% of the population covered by employer-based insurance for some or all of 2022. This was followed by Medicaid (18.8%), Medicare (18.7%), direct-purchase coverage (9.9%), TRICARE (2.4%), and VA and CHAMPVA coverage (1%).

Medicaid is a federal and state programme that provides health coverage to people with low income or resources, while Medicare is a federal insurance programme for people aged 65 or older, as well as younger people with disabilities or those with End-Stage Renal Disease. TRICARE is a health care programme for uniformed service members, military retirees, and their families, while VA and CHAMPVA coverage is for veterans and their families.

While the majority of Americans are covered by private insurance, public insurance programmes play a significant role in providing coverage for more vulnerable populations, including those with low incomes, older individuals, and people with disabilities. These programmes help ensure that a larger proportion of the population has access to necessary healthcare services.

How many people are covered by military insurance?

Military insurance is provided to military members, their families, and retirees. The health insurance plan for military personnel is called TRICARE, which offers comprehensive coverage, including medical, dental, and vision plans, as well as life insurance and pharmacy prescription options. Military insurance is available to those serving in the Army, Navy, Air Force, Space Force, Marines, or Coast Guard. Additionally, commissioned members of the National Oceanic and Atmospheric Administration (NOAA) and the U.S. Public Health Service (USPHS) are also eligible.

TRICARE provides coverage for soldiers and their families at little to no cost. It includes dental, vision, pharmacy, and life insurance coverage, as well as coverage for spouses and children. Soldiers have access to military hospitals and clinics worldwide and can choose from various in-network and out-of-network providers. TRICARE also offers special programs and services for families with special needs, such as autism care, hospice care, and cancer clinical trials.

According to the Servicemembers Group Life Insurance (SGLI) program, active-duty military personnel, reservists, and National Guard members called to active duty can purchase life insurance coverage ranging from $50,000 to a maximum of $400,000. This insurance is offered at low rates, and the premium is automatically deducted from the base pay of service members.

While the exact number of people covered by military insurance is not readily available, it includes active-duty service members, their families, retirees, and reservists. As of 2023, the monthly cost of the TRICARE Health Plan for a Private First Class Soldier (E3) was $1491. This provides an estimate of the number of people covered, assuming that each soldier has access to this insurance plan.

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