In 2009, the last full year before healthcare reform legislation went into effect, 15.4%—or about 46.3 million Americans—had no healthcare insurance, according to a Centers for Disease Control survey released Wednesday. This rate is slightly up (from 14.7% or 43.8 million Americans) from 2008.
The percentage of adults aged 18 to 64 years who lacked coverage at the time of contact by the CDC's National Center for Health Statistics increased from 19.7% in 2008 to 21.1% in 2009. A corresponding decrease in private coverage occurred among adults aged 18 64 from 68.1% in 2008 to 65.8% in 2009.
Also in 2009, individuals age 65 or younger with private health insurance were enrolled in a high deductible health plan— including 6.3% who were enrolled in a consumer directed health plan. Almost half of persons with a private plan obtained by means other than through employment were in high-deductible plans; about 20.4% of persons with private plans were in a family with a flexible spending account for medical expenses.
About 21% of individuals age 65 years or younger were covered by public plans. More than a third of children (37.7%) were covered by a public plan—compared with 14.4% of adults aged 18 64. Those children covered by a public health plan increased from 34.2% in 2008 to 37.7% in 2009—possibly due to expansion of children's coverage at the federal level in 2009.
In 2009, 11.8% of poor children and 12.1% of near poor children did not have health insurance. The percentage of near poor children who lacked health coverage decreased from 15.6% in 2008 to 12.1% in 2009. Meanwhile, the percentage of poor adults aged 18 64 years who lacked coverage at the time of the CDC survey increased from 37.7% in 2008 to 42.5% in 2009.
Approximately one in four persons under age 65 in Florida and Texas, and one in five persons under age 65 in California and Georgia, lacked coverage at the time of the CDC survey. By contrast, rates of non-coverage at the time of survey in Illinois, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania, Washington, and Wisconsin were lower than the national average.
For all persons under age 65 years, the largest age group without insurance were those aged 18 24 (29.6%). This area is anticipated to change quickly under provisions approved earlier this year that would allow young adults to stay on their parents' plans.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.