Census data shows health insurance coverage gains for black workers and children in 2021, but we can move forward with better policy

The number of workers covered by health insurance grew between 2020 and 2021 as the economy recovered from massive job losses linked to the coronavirus pandemic. Most people (91.7%) had health insurance coverage at some point during the year and the proportion of uninsured fell from 8.6% in 2020 to 8.3% in 2021.

Notably, the percentage of uninsured blacks fell from 10.4% in 2020 to 9.0% in 2021, representing a rare event in which the uninsured black rate fell below 10%.

In 2021, most people (54.3%) had health insurance through their employer (either the employer or a family member). The proportion of people with private health insurance of any kind (employment-based or through individual purchase) decreased slightly to 66.0%, while the proportion of those with a public plan increased to 35.7% (note that the types of coverage are not exclusive – one person can get There are two types of health insurance coverage.

The decline in private coverage in 2021 came largely from lower rates among those 65 and older, while those under 65 saw increased use of public health insurance, particularly Medicaid. This trend has been consistent throughout the pandemic as states expanded coverage in response to federal “continuing coverage requirements,” states that allow participants to maintain coverage even through a change in income eligibility have seen their federal Medicaid matching rate increase by as much as 6.2%. In the previous measurement period before the pandemic (2018-2020), Medicaid coverage remained essentially flat while private insurance coverage declined, resulting in increased rates of uninsured among black Americans and those living below the poverty line.1

This expansion of public health insurance coverage reduced the uninsured rate to 9.0% for black people in 2021. Black children and working-age adults saw their uninsured rates drop dramatically, from 5.9% to 4.3% for children and from 14.2% to 12.7% for adults. We can see consistent improvements in insurance rates in the South and for those below the poverty line – all signs are that expanding Medicaid eligibility through the public health emergency has had a significant positive impact on health insurance coverage.

Expanded public health insurance coverage lowered rates of uninsured blacks in 2021: Uninsured Rate by Race and Hispanic Origin, 2020 and 2021

a race 2020 2021
white, non-latin 5.4% 5.2%
black 10.4 9
Asia 5.9 6.2
Hispanic (any race) 18.3 18.3
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