PUBLIC AND PRIVATE HEALTH INSURANCE

Differences in coverage type and changes in coverage can be seen across groups. For example, in 2021, Hispanic individuals had the highest uninsured rate (18.3 percent), followed by Black (9.0 percent), Asian (6.2 percent), and non-Hispanic White (5.2 percent) people (Appendix Table C-1).

Lower uninsured rates for nonHispanic White and Asian individuals reflect higher private coverage rates.32 In 2021, non-Hispanic White individuals had the highest rate of private coverage (73.2 percent), followed by Asian (72.4 percent), Black (55.1 percent), and Hispanic individuals (48.8 percent) (Figure 8).

Although there was no significant change in private coverage between 2020 and 2021 for Hispanic, Asian, and Black individuals, private coverage rates declined by 0.7 percentage points among non-Hispanic White individuals.

Between 2020 and 2021, most race and Hispanic origin groups saw an increase in public coverage rates.

The increase in public coverage rates was similar for three groups. Non-Hispanic White individuals had public coverage increase 1.3 percentage points (to 34.6 percent), Black individuals had an increase of 1.4 percentage points (to 42.7 percent), and Hispanic individuals had an increase of 1.1 percentage points (to 37.0 percent).

However, there was no significant change in public coverage rates for Asian individuals. People in both expansion and nonexpansion states also experienced an increase in public coverage rates between 2020 and 2021.

Those in expansion states had a 1.4 percentage-point increase in public health insurance coverage (37.0 percent), while those in nonexpansion states had a 1.0 percentage-point increase in public coverage (33.1 percent).

Between 2020 and 2021, private coverage rates in expansion states fell 0.9 percentage points to 67.1 percent. When looking at health insurance by work experience or disability status, we restrict our analyses to adults aged 15 to 64.

For many adults aged 15 to 64, health insurance coverage is related to work status as many workers may be covered by their employers’ health plans. Indeed, workers were more likely than nonworkers to be covered by private health insurance.

In 2021, 85.0 percent of full-time, year-round workers were covered through a private insurance plan, compared with 66.5 percent of those working less than full-time, year-round. Those who did not work were the least likely to have private health insurance coverage at 50.3 percent.

Both full-time, year-round workers and those who did not work experienced a decrease in private coverage rates between 2020 and 2021 (by 2.0 percentage points and 1.6 percentage points, respectively). Rates of public coverage followed a different pattern.

Nonworkers were more likely than workers to have public coverage (41.2 percent of nonworkers and 12.1 percent of workers).

Full-time, year-round workers were the least likely to have public coverage at 7.9 percent, while 22.6 percent of workers who worked less than fulltime, year-round were covered by public coverage in 2021. Between 2020 and 2021, there was an increase in public coverage across work statuses.

The percentage of full-time, yearround workers with public coverage increased by 1.8 percentage points, while public insurance coverage rates for those who worked less than full-time, yearround increased by 1.6 percentage points.

For nonworkers, public coverage increased by 1.8 percentage points. People with a disability were less likely than people with no disability to have private health insurance coverage and more likely to have public coverage.

In 2021, 46.3 percent of adults with a disability had private coverage, compared with 73.9 percent of adults with no disability. At the same time, 52.3 percent of adults with a disability and 17.2 percent with no disability had public coverage.

Between 2020 and 2021, public coverage increased 0.9 percentage points among people with no disability but did not statistically change for people with a disability during this period.33 There are also differences in the distribution of coverage type by marital status.

For example, in 2021, 81.7 percent of married adults aged 19 to 64 held private coverage, compared to 63.1 percent of those who were not married. Married adults were also less likely to hold public coverage (13.4 percent) than their nonmarried counterparts (24.2 percent).

Although there was no significant change in private coverage for either group between 2020 and 2021, the percentage of married adults with public coverage increased by 1.1 percentage points. Public coverage rates also increased among those who were not married by 0.7 percentage points during the same period.

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