Insurance Coverage: Who's Protected?

As of 2022, nearly 304 million people in the United States had some kind of health insurance, a significant increase from around 257 million in 2010. However, there were still over 25 million people in the US without any health insurance in 2022. The US does not have universal healthcare, and healthcare costs are covered by a mix of private and public insurance programs. In 2021, almost 50% of the insured population in the US were insured through their employers, while 18.9% were insured through Medicaid, and 15.4% through Medicare.

How many people have health insurance in the US

In 2022, 92.1% of people in the US, or 304 million, had health insurance at some point during the year. This represents an increase in the insured rate and number of insured people from 2021, when 91.7% (300.9 million) were covered. Private health insurance coverage is more prevalent than public coverage, with 65.6% and 36.1% of the population holding private and public insurance, respectively.

The most common type of health insurance coverage in the US is employment-based insurance, which covered 54.5% of the population for some or all of 2022. This is followed by Medicaid (18.8%), Medicare (18.7%), direct-purchase coverage (9.9%), TRICARE (2.4%), and VA and CHAMPVA coverage (1.0%).

The rate of Medicare coverage increased by 0.3% between 2021 and 2022, while the uninsured rate among working-age adults aged 19-64 decreased by 0.8% to 10.8%. The number of nonelderly uninsured individuals in the US has been on a downward trend, dropping to 25.6 million in 2022 from 27.5 million in 2021. This decrease is partly attributed to coverage expansions put in place by the Affordable Care Act (ACA), which served as a safety net during the coronavirus pandemic.

While the US population was approximately 330 million in 2019, with 59 million people over the age of 65 covered by Medicare, there were 273 million non-institutionalized persons under 65. Of these, 159 million obtained employer-based coverage, 84 million had non-employer-based coverage, and 30 million were uninsured.

How many people have private insurance

In the UK, there are approximately 8 million people with active private health insurance policies, which equates to around 13% of the British population. This number is expected to increase, as 53% of people say that they would like to invest in some form of health insurance scheme for their employees or themselves and their families.

The UK's National Health Service (NHS) provides free medical treatment to all UK residents, so why do people opt for private health insurance? The main advantage of private cover is faster access to medical treatment. With the NHS, patients may have to wait several weeks or months for treatment, whereas those with private insurance can usually be booked in with a private clinic or consultant within a week or at a convenient time for them. Private insurance also offers patients the option of a private room rather than sharing a ward.

Private health insurance is particularly useful for those needing serious procedures or diagnostic treatment. For example, the average cost of health insurance is lower than the cost of hip replacement or knee replacement surgery, gall bladder removal, or cataract surgery.

In the US, the number of nonelderly uninsured individuals has been on a downward trend, dropping by nearly 1.9 million from 27.5 million in 2021 to 25.6 million in 2022. This decrease in the number of uninsured individuals is partly due to coverage expansions put in place by the Affordable Care Act (ACA), which served as a safety net for people who lost their jobs or faced other economic disruptions during the coronavirus pandemic.

How many people are covered by Medicaid

Medicaid is a federal and state-funded health program that provides medical coverage for low-income individuals and families in the United States. The program is run by individual states following federal guidelines. As of 2022, over 90 million Americans were enrolled in the program, a significant increase from the roughly 50 million enrollees in 2012. This number includes people enrolled in both Medicaid and the Children's Health Insurance Program (CHIP). CHIP was introduced in 1997 to provide low-cost health coverage for children under the age of 18 in families that earn too much to qualify for Medicaid but not enough to purchase private health insurance.

Medicaid enrollees fall into four main groups: children, adults under 65, seniors aged 65 or older, and disabled people. Children constitute the largest group, accounting for approximately 37% of enrollees. However, their share of Medicaid expenditures is relatively small, at around 15%. On the other hand, disabled people, who make up about 11.4% of total enrollment, are responsible for 33.4% of total expenditures.

In February 2024, 76,289,951 individuals were enrolled in Medicaid across 51 states and the District of Columbia. This number includes adults and children but does not include those with emergency Medicaid coverage, family planning-only coverage, or limited benefit dual eligibility. The number of individuals covered by Medicaid varies from state to state, as eligibility limits for CHIP differ by state as well.

Medicaid is the third-largest payer in the nation's healthcare bill, after private insurance and Medicare, accounting for about 19% of the total healthcare expenditure. It is a vital source of funding for hospitals, community health centers, physicians, and nursing homes. The program's expenditures have increased over the years, reaching nearly $824 billion for the first time in 2022. California has the highest Medicaid spending, followed by New York, Texas, and Pennsylvania.

How many people are covered by Medicare

Medicare is a federal health insurance program for individuals aged 65 or older, or for those younger than 65 with certain health conditions. The program was established in 1965 and has since expanded its coverage.

In 2019, 61.2 million people enrolled with Medicare. This figure increased to over 61 million in 2020, and further to over 64 million in 2024. Of the 61 million recipients in 2020, around 14%—approximately 9 million people—were under 65 years of age.

Medicare is divided into several parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). In 2019, 60.9 million people received Medicare Part A, 56.1 million received Part B, 22.2 million were enrolled in Part C, and 47.2 million received Part D.

Medicare cost the US $917 billion in 2020 and is estimated to cost up to $1.78 trillion by 2031. In 2018, 15% of the total federal spending budget was spent on Medicare, and this number is projected to rise to 18% of the federal budget by 2029.

How many people are covered by their employer

In the United States, employer-sponsored health insurance is a significant source of coverage for millions of people. As of 2022, approximately 78% of the population is eligible for health insurance through their employers. This means that a large portion of Americans rely on employer-sponsored health coverage for their medical needs.

According to the Kaiser Family Foundation, employer-sponsored insurance covers almost 155 million nonelderly people. In 2021, the average annual premiums for employer-sponsored health insurance were $7,739 for single coverage and $22,221 for family coverage. These figures represent a 4% increase over the previous year, outpacing the growth in workers' wages and inflation.

The percentage of people covered by their employers can vary depending on company size and industry. Larger companies often have more negotiating power to secure comprehensive coverage with lower premiums, while smaller companies may offer more basic plans with higher deductibles and copayments due to limited resources. In 2021, 59% of firms offered health benefits to at least some of their workers, and this likelihood increased with firm size. Only 49% of firms with 3 to 9 workers offered coverage, while nearly all firms with 1,000 or more workers provided health benefits to at least some employees.

The type of health insurance plan offered also influences the extent of employer-sponsored coverage. Preferred Provider Organization (PPO) plans are the most common type provided by employers, with 47% of all firms offering them in 2023. High Deductible Health Plans with Savings Options (HDHP/SO) are also popular, offered by 29% of firms in the same year.

It is worth noting that employer-sponsored health insurance brings several benefits to both employers and employees. For employees, it reduces the financial burden of medical expenses, providing peace of mind and access to necessary medical care. Employers can benefit by attracting and retaining top talent, boosting morale and productivity, and potentially enjoying tax incentives.

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