Questions for Emily P. Zammitti, M.P.H., Associate Service Fellow and Lead Author on “Changes in Characteristics of Chronically Uninsured Adults: Early Release of Estimates From the National Health Interview Survey, 2010–September 2016.”
Q: What do you mean by the “chronically uninsured?”
EZ: For the purposes of this report, persons were defined as chronically uninsured if they were uninsured at the time of interview and had lacked coverage for more than 1 year.
Q: What groups are more likely to be chronically uninsured?
EZ: We have to be careful about how we speak about the results of this report. The focus of this report is the population who are chronically uninsured. Therefore it does not address which groups are more likely to be chronically uninsured. Among the chronically uninsured, certain groups are larger than others. In the first 9 months of 2016, the proportion of chronically uninsured adults who lived in the South was larger than the proportion who lived in the Northeast, Midwest, or West regions. The proportion who were aged 45-64 was larger than the proportion who were aged 18-25, 26-34, and 35-44. The proportion who were Hispanic was larger than the proportion who were non-Hispanic white, non-Hispanic black, non-Hispanic Asian, and non-Hispanic other race. The proportion who rated their health as excellent or very good was larger than the proportion who rated their health as either good or fair or poor. A major focus of this report is how these proportions have changed since 2010.
Q: How many of the chronically uninsured are younger people who in many cases are healthy vs. older people who are much more likely to need insurance?
EZ: In the first 9 months of 2016, we estimate that 16% of chronically uninsured adults aged 18-64 were aged 18-25, 25.2% were aged 26-34, 26.8% were aged 35-44, and 32% were aged 45-64. Since 2010, the proportion of chronically uninsured adults who were aged 18-25 has decreased, and the proportion who were aged 35-44 and 45-64 increased. For this report, we did not disaggregate health status by age.
Q: Are there more chronically uninsured people in states that did not expand Medicaid?
EZ: We did not look at the chronically uninsured population stratified by state Medicaid expansion status for this report. However, we do look at the percent who are uninsured at the time of interview, which includes both chronically and short-term uninsured, by state Medicaid expansion status in our quarterly Health Insurance Early Release report. The percentage who are uninsured is higher in states which have not expanded Medicaid, compared with states which have expanded Medicaid.
Q: What in this new analysis did you find most interesting?
EZ: The first figure in our report shows that since 2010, the percentage of adults aged 18-64 who are chronically uninsured has been cut by more than half from 16.8% in 2010 to 7.6% in the first 9 months of 2016.
Q: When will you have full-year numbers available for 2016?
EZ: Full year 2016 Early Release data will be available on May 17th, 2017 through the Research Data Centers. That’s also when the next Health Insurance Early Release report will come out. Full year final data are expected to be released at the end of June 2017, six months after the completion of data collection.
Q: What do you make of the finding that the percent of chronically uninsured who are unemployed has been dropping while the percent who are employed has been increasing?
EZ: We don’t propose potential explanations for the results of this report, that’s outside of the scope of our work, but we did see a decrease in the proportion of chronically uninsured adults aged 18-64 who were unemployed from 16.3% in 2010 to 10.1% in the first 9 months of 2016, with a corresponding increase in the proportion who were employed during this time period.
Q: Anything else you feel is noteworthy about your study?
EZ: lthough the majority of chronically uninsured adults rate their health as excellent or very good, this proportion has not changed significantly from 2010 to the first 9 months of 2016. This means that the chronically uninsured population aged 18-64 is not more or less healthy (according to their self-rated responses) in the first 9 months of 2016 than in 2010.