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In 2014 — after most of the Affordable Care Act went into effect — the share of people without health insurance dropped from 14.5% to 11.7%. Since then, the share of people in the United States without health insurance has reached as low as 8.6% (in both 2016 and 2021), but gaps in coverage persist among certain racial and ethnic groups.

Disparities in coverage are influenced by a variety of factors, such as differences in income, occupation, poverty levels, location, and age. Federal and state policies can also affect access to healthcare.

By understanding these differences in coverage, healthcare professionals may find ways to make healthcare more accessible and equitable for all people, no matter their race, gender, ethnicity or age.

What races have the lowest healthcare coverage?

As of 2021, 8.6% of Americans are uninsured, down from 15.1% a decade prior. But when you look at uninsured rates by race and ethnicity, there is a wide range in coverage. Overall, the uninsured rate was lowest for non-Hispanic white people at 5.7% in 2021, while it was highest at 18.8% of non-Hispanic American Indian and Alaska Native individuals. Hispanic or Latino people also had one of the highest uninsured rates in the country at 17.7%.

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When it comes to private coverage, white non-Hispanic people and Asian non-Hispanic individuals had the highest rates of coverage at about 74.2% and 74%, while American Indian and Alaska Native, non-Hispanic people had the lowest at 43.1%. However, some groups had lower rates of private coverage but higher rates of public coverage.

How does employment status impact health insurance coverage?

Employed adults (ages 19 to 64) had the highest rates of private insurance coverage, while those who were unemployed had the lowest rates of private coverage; this pattern spans across each race and ethnicity group.

More than three-fourths of employed adults had private coverage (81.3%) compared to 41.4% of unemployed adults or half of all adults not in the labor force.

What are the consequences of being uninsured?

According to a report from the Department of Health and Human Services, uninsured adults are less likely to get the preventative care they need for things like diabetes, cancer, and heart problems. Kids without insurance might not get the right treatment for chronic health issues such as asthma or receive important services like dental check-ups and vaccines.

Pricey out-of-pocket Medicare costs may lead people to postpone needed care. Medical debt is also common among uninsured people, according to the report.

The end of emergency pandemic measures may lead to more uninsured Americans

A pandemic-era plan that kept people enrolled in Medicaid for longer than they were initially eligible is coming to an end in April 2023. If someone was enrolled in Medicaid at the beginning of the pandemic in March 2020 or if they became eligible for Medicaid at anytime during the pandemic, they would stay eligible even if their income increased. This was part of the Medicaid continuous enrollment provision. But states are required to reverify if each Medicaid recipient still qualifies for the program.

The Biden administration estimates that close to 15 million of the nearly 90 million Americans who currently receive Medicaid benefits could lose coverage. Medicaid and the Children’s Health Insurance Program (CHIP) provide health insurance to low-income families, children, seniors and people with disabilities.

As of 2022, 88.5 million Americans were enrolled in Medicaid or CHIP, according to the Centers for Medicare and Medicaid Services.

How was the data collected?

The data comes from the 2021 American Community Survey (ACS) one-year estimates. This survey looks at the differences in health insurance coverage by employment status, poverty levels, and living arrangements. Data from the ACS is pulled from over 3.5 million households across the country through the Census Bureau.

To learn more about healthcare coverage in the US, read about health insurance coverage by state and the data surrounding Affordable Care Act. Get the data directly in your inbox by signing up for our newsletter.

Health Insurance Coverage by Race and Hispanic Origin: 2021