Insurance coverage sees big gains between 2019 and 2021

The U.S. Department of Health and Human Services reported large gains in health insurance coverage between 2019 and 2021, with the national uninsured rate hitting an all-time low early last year.

The report shows larger gains in coverage for demographic groups with higher historical uninsured rates, including younger adults, Latino individuals, American Indian, and non-English speaking adults. Adult age groups 19-34 and 35-49 both saw a 1 percentage point decline in uninsured rates, as did Latinos. American Indians saw a 0.9% decrease and non-English speakers saw a 1.5% decrease.

Nationally, the uninsured rate for people under 65 fell from 11.1% in 2019 to 10.5% in 2021, with the biggest gains occurring in several states with recent Medicaid expansions, including Maine (-3.2 percentage points) and Idaho (-2.1 percentage points).

The decline in the uninsured rate was largest for those with household incomes between 100 and 250 percent of the Federal Poverty Level.

Coverage gains varied widely across Asian American and Native Hawaiian/Pacific Islander and Latino communities; disaggregating data for these groups reveals important differences in coverage patterns.

Federal policies – such as an enhanced Marketplace access to a Special Enrollment Period in 2021, expanded and enhanced premium tax credits under the American Rescue Plan, enhanced funding for Marketplace outreach and enrollment assistance, and the Medicaid continuous enrollment provision during the COVID public health emergency – likely contributed to gains in health coverage since 2019, particularly among low-income populations and communities of color.

Earlier, HHS released a snapshot of the national Marketplace plan selections, which showed that nearly 16 million Americans have signed up for coverage since the start of the 2023 Marketplace open enrollment period, a 13% increase over last year.