Uninsured numbers fall from 2013 to 2014

The number of Americans without health insurance shrank from 2013 to 2014, as did the gap in coverage rates between whites and non-whites, according to two new studies.

The latest report on health insurance coverage from the U.S. Census Bureau finds that 10.4% of the population lacked health insurance in 2014, compared with 13.3% in 2013. The increase in coverage occurred among both people with private insurance and those with some form of government coverage.

The greatest percentage-point increase in coverage was among what the report labels direct-purchase, which grew by 3.2 percentage points to include 14.6% of Americans. That was followed by a 2.0 percentage point increase of those covered by Medicaid, to 19.5% of the population. The rate of private coverage went up by 1.8 percentage points to 66%.

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A second study, published online in Health Affairs, shows that the gap in the uninsurance rate between black and white adults narrowed from 10.7% to 6.7% between the third quarter of 2013 and the end of 2014. At the start of the period 25.5% of black adults and 14.8% of white adults were uninsured, compared with 17.2% and 10.5%, respectively, at the end of the period.

Hispanic adults also saw a decline in the percentage of uninsured, from just over 40% to 31.8%, narrowing the uninsurance gap with whites from 25.3% to 21.3%.

Data for the Census Bureau report came from the Current Population Survey Annual Social and Economic Supplement, while the Health Affairs study data came from the 2014 National Health Interview Survey.

The authors of the Health Affairs study attribute the narrowing of the uninsurance gap to the expansion of Medicaid eligibility and start of the insurance exchanges and availability of federal subsidies under the Affordable Care Act (ACA). The exchanges began operating in the third quarter of 2013.

A third recent report, prepared by the National Academy for State Health Policy, breaks down the decline in the number of uninsured according to whether the state established its own exchange or uses the federal exchange. Among the former group-which includes 14 states and the District of Columbia-Kentucky had the largest decrease, at 41%. Among states using the federal marketplace, North Dakota and Ohio tied for the largest decreases at 24%.

NEXT: Insurance rates based on income and education

In 2012 the U.S. Supreme Court ruled that states could choose whether or not to expand Medicaid eligibility under the ACA, and the Health Affairs study compares coverage changes among racial and ethnic groups according to expanded eligibility. It finds that while uninsurance declined for all groups in the expansion states, whites saw no significant declines in the non-expansion states. Consequently the difference in white/black uninsurance rates fell from 7.4 to 3.3 percentage points in the expansion states but from 11.1 to 4.8 percentage points in non-expansion states.

For Hispanic adults the disparity with whites also declined in both expansion and non-expansion states to 19.3 and 23.0 percentage points, respectively in 2014. The study does not specify the actual percentages of uninsured among Hispanic adults, but notes that in expansion states, surprisingly, the ratio of Hispanic to white uninsurance was higher in 2014 than 2013.

The Census Bureau report found that insurance coverage remains strongly correlated with education and household income. In 2014, 95% of Americans age 25 to 64 with a graduate or professional degree were insured, compared with 82.3% of high school graduates and 69.4% of those without a high school diploma.

Similarly, nearly 95% of people with household incomes of $100,000 or more had coverage, compared with 83.4% of Americans with incomes under $25,000. However, the number of insured people with incomes under $25,000 grew by 4.3 percentage points from 2013 to 2014, while the rate grew by less than one percent among households with incomes of $100,000 or more.