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Uninsured Rate Will Rise to 8.9% by 2034, CBO Finds
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The percentage of Americans who do not have health insurance, which currently stands at around 7.2%, is expected to increase steadily over the years, reaching 8.9% by 2034, according to the latest data presented by the Congressional Budget Office.
In a report published in Health Affairs, the CBO said this trend is largely the result of the end of Medicaid policies related to the COVID-19 pandemic, the expiration of enhanced subsidies available through the Affordable Care Act health insurance markets and a surge in immigration that began in 2022.
The largest increase in the uninsured population will occur among adults ages 19 to 44. Employment-based coverage will be the predominant source of health insurance, and as the population ages, Medicare enrollment will grow significantly, according to the CBO.
After a higher-than-expected number of registrations in 2023, the number of registrations in the market is expected to reach an all-time high of twenty-three million people in 2025.
WHAT IS THE IMPACT?
Jessica Hale, co-author of the Health Affairs study, said today during a press call that the estimates are based on the assumption that legislation enacted by May 12, 2024 remains in effect.
CBO projections show that health insurance coverage varies considerably by age. In 2024, people between the ages of 19 and 44 will have a lower coverage rate than people of other ages. That gap will widen through 2034, Hale said, in part due to reduced enrollment in marketplace plans.
Children aged 18 and under have greater Medicaid coverage and CHIPS than any other group, with enrollment expected to reach 32 million by 2034. Younger adults, aged between 19 and 44, will have the highest uninsured rate at that time, at around 17 million.
Older adults (65 and older) will have the lowest uninsured rate, about one million, in 2034. They will also have the highest enrollment in Medicare, which is expected to grow substantially, from 54 million to 66 million over the next decade. . .
Medicaid coverage will likely tell a different story.
“Numerous data sources indicate that the number of people with Medicaid has increased recently,” Hale said. “We expect the recent increase to reverse after ongoing Medicaid eligibility ends. This is also why we don’t expect employer-based coverage to increase much in response.”
The CBO projection of population size each year on average during the study period increased by 8.8 million people over last year’s projection, primarily due to greater net immigration. According to Hale, this increase will particularly increase enrollment in employer-based coverage and increase the number of uninsured people.
To a much lesser extent, increased immigration will also increase Medicaid and marketplace coverage. From 2024 to 2033, the average annual enrollment in market coverage is 3.2 million more than previously projected. This increase, according to CBO, is due to greater-than-expected transitions from Medicaid to marketplace coverage and a greater-than-expected impact from the availability of enhanced marketplace subsidies.
THE BIGGEST TREND
Employment-based coverage will continue to be the largest source of health insurance, with enrollment between 164 million and 170 million, the data showed.
As the population ages, Medicare enrollment will increase from 60 million in 2023 to 74 million in 2034. Following higher-than-expected enrollment numbers in 2023, enrollment through the marketplaces established by the Cares Act is anticipated. Affordable prices will reach a new high of 23. million in 2025 and then decline by about seven to eight million after 2025, when enhanced market subsidies expire.
Additionally, following the expiration of Medicaid’s COVID-19 pandemic-related continued eligibility provisions, the number of people with multiple sources of coverage will decrease from 29 million in 2023 to 21 million in 2034.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Publication in the media.