Parsing NY’s progress on uninsured

by Bill Hammond |  | NY Torch

cardiogram-pulse-trace-1461880398Nt8Newly released Census Bureau data on the nation’s declining uninsured rate held good news and bad news for New York.

On the plus side, the share of New Yorkers lacking health insurance dropped to a new low of 7.1 percent in 2015, which was 2.3 points lower than the U.S. rate of 9.4 percent.

That translates to a net increase of 689,000 845,000 state residents with coverage since the Affordable Care Act took full effect in 2014.

On the disappointing side, the pace of New York’s progress toward universal coverage continued to slightly lag the national average. The state’s uninsured population dropped by 33 percent between 2013 and 2015, compared to 34 percent for the country as whole. That was enough for New York’s uninsured rate to slip from 14th- to 20th- lowest among the 50 states and the District of Columbia.

Among the states passing it in that ranking were Kentucky (which went from 34th to 11th) and West Virginia (32nd to 10th).

This was despite New York’s wholehearted embrace of the ACA and its heavy spending on health care, both in the private sector and through the Medicaid program for the poor.

Holding the state back was sub-par growth in private insurance coverage. Between 2013 and 2015, the number of New Yorkers with employer-based plans actually dipped slightly in the Census Bureau survey. And the share with “direct purchase” plans–the type sold directly to individuals and families through Obamacare exchanges–increased 14 percent, well below the national average of 39 percent.

Enrollment figures from the New York State of Health, the state’s ACA purchasing exchange, have painted a similar picture.

This is likely due to New York’s unusually high premiums, which in turn are driven by high health-care costs and state-imposed mandates and taxes on insurance.

Enrollment in New York’s expansive version of the government-sponsored Medicaid health plan for the poor rose by 14 percent, a little below the U.S. average of 16 percent. This may simply reflect the fact that there was less room to grow: The survey showed one in four New Yorkers were enrolled in Medicaid in 2015, a higher share than all but six other states.

UPDATE: Here’s a spreadsheet with more detail.