More About Matt Broaddus

Matt Broaddus

Broaddus joined the Center in December 1999 and is a Research Analyst in the Health Division.

Full bio and recent public appearances | Research archive at CBPP.org


Coverage Gap Widening Between Medicaid Expansion States and Others

September 18, 2014 at 11:53 am

People in states that have adopted health reform’s Medicaid expansion had a lower uninsured rate in 2013 (before the expansion took effect) than people in non-expansion states — and non-expansion states are falling further behind in 2014, several recent government and independent surveys reveal.

Some 14.1 percent of the people in the 27 states (including Washington, D.C.) that have expanded Medicaid lacked health insurance in 2013, compared to 17.3 percent in the 24 non-expansion states, according to the Census Bureau’s American Community Survey (see chart).

Next year’s Census data, which will reflect the substantial coverage gains expected in expansion states in 2014 due to the expansion (which took effect January 1), should show a further widening of this coverage gap.

Results from several independent surveys — and this week from the Centers for Disease Control and Prevention (CDC), the first government survey data showing health reform’s early impacts — show that this is already happening.  For example, the Urban Institute’s Health Reform Monitoring Survey found that the uninsured rate for non-elderly adults in expansion states fell from 16.2 percent to 10.1 percent between the third quarter of 2013 and the second quarter of 2014, compared to a decline from 20.0 percent to 18.3 percent in non-expansion states.

Health reform’s Medicaid expansion creates a pathway to coverage for all non-elderly adults with incomes up to 138 percent of the poverty line, including, for the first time, low-income adults without children.  However, the 2012 Supreme Court decision upholding health reform made the expansion a state option.  States can opt in to the expansion at any time; the federal government will pick up all of the cost through 2016 and nearly all of the cost thereafter.

Census Data Show Continued Wide Disparities in Health Coverage

September 17, 2014 at 11:46 am

Certain groups of Americans continue to be uninsured at particularly high rates, the new Census Bureau data show.  African Americans and Hispanics, residents of the South and West, adults under age 35, and households with incomes under $50,000 had uninsured rates in 2013 well above the national average of 13.8 percent (see chart).  Hispanics’ 24.3 percent uninsured rate, for example, was nearly twice the national average.

These estimates, from the Current Population Survey (CPS), are the best source for comparing coverage rates among population groups in a single year but can’t be compared to CPS estimates from previous years because of changes to the CPS questions for 2013.  For health coverage trends over time, one should look instead to Census’ American Community Survey data, which we discussed yesterday.

Health reform’s major coverage expansions — the Medicaid expansion in many states to cover more low-income adults and the availability of subsidies for private marketplace coverage — will help reduce the disparities in health coverage among population groups.  But the expansions didn’t begin until 2014, so the new Census figures for 2013 don’t capture those coverage gains.  The Centers for Disease Control and Prevention released data yesterday covering the first quarter of 2014, and they show that the coverage gains in 2014 were greatest among some of the groups with the highest uninsured rates, including young adults, Latinos, and low-income households.

New CDC Figures Show Health Coverage Gains in the First Quarter of 2014

September 16, 2014 at 3:14 pm

Separate from the Census Bureau’s release today of official health coverage figures for 2013, the Centers for Disease Control and Prevention (CDC) issued preliminary data this morning showing that the ranks of the uninsured fell in the first quarter of 2014 by 3.8 million people.  The CDC data provide the first government survey data showing the early impacts of health reform’s major coverage expansions, which took effect in January 2014, in reducing the ranks of the uninsured.

The CDC figures are consistent with four independent surveys that also show significant gains in health coverage in 2014, particularly among states that have adopted health reform’s Medicaid expansion.

Some 13.1 percent of Americans were uninsured in the first quarter of 2014, the CDC data show, a 1.3 percentage-point decline from 2013 and the lowest uninsured rate since the CDC first collected these data in 1997.

Coverage gains were greatest among population groups historically least likely to have coverage.  The uninsured rate for adults under 26 plummeted from 26.5 percent in 2013 to 20.9 percent in the first quarter of 2014.  People in families under 200 percent of the poverty line, Latinos, African Americans, and people with less than a high school education also experienced disproportionately high coverage gains over this period.

The coverage gains among non-elderly adults were more than twice as large in states that have adopted the Medicaid expansion as in non-expansion states, widening the gap between the uninsured rates in the two groups of states from 4.3 percentage points to 5.8 percentage points.  (Expansion states have a non-elderly adult uninsured rate of 15.7 percent, compared to 21.5 percent for non-expansion states; see graph.)

The CDC data were collected in January-March and do not fully capture the significant enrollment growth in states’ Medicaid programs and health reform marketplaces that took place towards the end of this period, as the March 31 deadline for enrolling in marketplace coverage approached.  Data that include the second quarter of 2014 — as several of the independent surveys cited above did — will likely show even larger coverage gains.  For example, the Urban Institute’s Health Reform Monitoring Survey found that the uninsured rate among adults aged 18-64 fell from 17.9 percent to 13.9 percent between the third quarter of 2013 and the second quarter of 2014.

Later today, the Census Bureau may also release similar preliminary estimates for early 2014, but these estimates — unlike the CDC estimates discussed here — are the first in a new series and thus can’t be compared to estimates from earlier years.

Census Data Show Uninsured Rate Fell Slightly in 2013, Continuing Earlier Progress

September 16, 2014 at 12:55 pm

Some 14.5 percent of Americans were uninsured in 2013, Census figures released today based on the American Community Survey (ACS) show, a slight but statistically significant reduction from 2012’s 14.8 percent and well below the recent high of 15.5 percent in 2010 (see graph).

The most widely used source of health coverage information is the Current Population Survey (CPS), but, as Census officials explained this morning, changes instituted to it in 2013 don’t allow for a historical analysis using CPS data.

Much of the improvement in health coverage since 2010 reflects health reform provisions permitting young adults to stay on their parents’ health plans until age 26 and building upon previous coverage gains for children under Medicaid and the Children’s Health Insurance Program by requiring states to keep their existing eligibility rules and procedures.

The results are for 2013 and so do not reflect the coverage gains in 2014 resulting from the major ACA coverage provisions, which took effect on January 1 — namely, the Medicaid expansion and subsidized marketplace coverage.  But updated data from four independent surveys show substantial reductions in the number and percentage of uninsured in 2014, particularly among states taking up the Medicaid expansion.

Consistent with those independent surveys, the Centers for Disease Control and Prevention (CDC) today released preliminary survey results showing a 1.3 percentage-point decline in the uninsured rate between 2013 and the first quarter of 2014, reflecting a 3.8 million reduction in the number without health coverage.  CDC data that include the second quarter of 2014 (as some of the independent surveys cited above did) will likely show even larger coverage gains.

The CDC’s estimated 13.1 percent uninsured rate is the lowest since it began collecting these data in 1997.  (The CDC data are not directly comparable to the Census data cited above.)

What to Know About Next Week’s Health Coverage Data

September 11, 2014 at 4:25 pm

The Census Bureau will release estimates Tuesday of the number and share of Americans without health coverage in 2013, based on its annual Current Population Survey (CPS).  While the CPS is the most widely used source of health coverage information, significant changes in its health coverage questions instituted for 2013 — the result of a multi-year Census initiative to improve the reliability and accuracy of the survey’s health coverage estimates — mean that the 2013 results cannot be compared to those for prior years, as we explain in a new report.  Moreover, because the CPS estimates are for 2013, they will not show the effects of health reform’s major coverage expansions, implemented starting in January 2014.

Analysts and policymakers should therefore look to other available data sources as well, including other federal and private surveys.  For example, the Census Bureau also will issue Tuesday the health coverage results from its American Community Survey (ACS).  Unlike the CPS, the ACS health insurance data for 2013 will be a part of a consistent data series back to 2008 and hence will allow analysis of changes in health coverage over recent years.

Preliminary results from the Centers for Disease Control and Prevention’s (CDC) National Health Interview Survey provide important clues about the upcoming Census estimate (under the ACS) of the change in health coverage in 2013.  The CDC data show that the share of Americans without health coverage remained stable between 2012 and 2013, as did rates of private coverage, Medicaid coverage, and coverage for particular groups of Americans.  These data show the uninsured rate rose from 14.5 percent in 2007 to 16.0 percent in 2010, then fell to 14.7 percent by 2012, and remained essentially unchanged (in statistical terms) at 14.4 percent in 2013.

Click here to read the full report.