Medicaid expansion and more access to private insurance options through the Affordable Care Act is pushing the level of uninsured down, both nationally and in Iowa, according to a report released Tuesday by the U.S. Census Bureau.
The number of uninsured Americans dropped by about 4 million between 2014 and 2015, according to the report. In 2015, the percentage of people without health insurance was 9.1 percent, or 29 million, down from the 10.4 percent, or 33 million, the year before.
The drop in the number of uninsured comes from increases in both private health insurance coverage and government coverage. The rate of private coverage increased to 67.2 percent in 2015 — up from 66 percent in 2014 — and the government coverage rate rose to 37.1 percent — up from 36.5 percent the year before.
The greatest shift in coverage between 2014 and 2015 was the change in direct-purchase health insurance, the report said. That increased by 1.7 percentage points to cover 16.3 percent of people (52 million), up from 14.6 percent (46 million) in 2014.
Iowa was one of five states to record an uninsured rate at or below 5 percent, according to the report.
The number of uninsured Iowans fell by 34,000 from 189,000, or 6.2 percent, in 2014 to 155,000, or 5 percent, in 2015.
Iowa is one of 28 states and the District of Columbia to expand Medicaid. The state created the Iowa Health and Wellness plan — which begin Jan. 1, 2014 — for adults with an income of up to 133 percent of the Federal Poverty Level. The number of Iowans without insurance stood at 248,000 in 2013.
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In both 2014 and 2015, the uninsured rate was higher in states that did not expand Medicaid than in those states that did at all levels of poverty, according to the report.
More than 100,000 Iowans received health care through the Iowa Health and Wellness plan in 2015.
Other highlights from the report:
• The rate of private coverage increased by 1.2 percentage points, to 67.2 percent, in 2015 — up from 66 percent in 2014.
• The government coverage rate increased by 0.6 percentage points to 37.1 percent — up from 36.5 percent in 2014.
• For the second year in a row, the percentage of people without health insurance dropped for every single age group under 65.
• In 2015, the percentage of uninsured children under age 19 was 5.3 percent — down from 6.2 percent in 2014.
• Between 2014 and 2015, the overall rate of health insurance coverage increased for most race and Hispanic-origin groups.