New HHS Report Shows Gains in Health Coverage Under Biden-Harris Administration from 2019 to 2021

Administration policies helped increase coverage among younger adults, Latino individuals, American Indian/Alaska Native, and non-English speaking adults

Today, the U.S. Department of Health and Human Services (HHS) issued a new report showing that Biden-Harris Administration efforts were linked to large gains in health insurance coverage of Americans between 2019 and 2021. The Biden-Harris Administration has made expanding access to health insurance and lowering health care costs for America’s families a top priority, and under its leadership, the national uninsured rate reached an all-time low early in 2022. The report, from the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE), shows that larger gains in coverage occurred for demographic groups with higher historical uninsured rates, including younger adults, Latino individuals, American Indian/Alaska Native, and non-English speaking adults.

“The Biden-Harris Administration has worked tirelessly to expand access to health insurance and lower costs for America’s families,” said HHS Secretary Xavier Becerra. “We know that access to quality, affordable health care is key to healthier lives, economic security, and peace of mind. As we move forward, the Department of Health and Human Services will continue to do everything we can to protect, expand, and strengthen the programs that provide the quality, affordable health care Americans rely on and deserve.”

Earlier this week, HHS also released its most recent snapshot of national Marketplace plan selections, including State-based Marketplaces, which revealed that nearly 16 million Americans have signed up for coverage since the start of the 2023 Marketplace Open Enrollment Period, a 13 percent increase over last year.  With more than 1.8 million more Americans signing up for coverage, Affordable Care Act (ACA) Marketplace enrollment in 2023 continues to outpace previous years, an encouraging sign that efforts to further increase the number of Americans with health insurance are succeeding.

The deadline for signing up for coverage through the HealthCare.gov Marketplace is January 15, 2023. People who do not currently have health insurance or are already in a Marketplace plan can go to HealthCare.gov to submit or update their applications until January 15, 2023, for coverage beginning February 1, 2023.

Key points from today’s ASPE report include the following:

• Nationally, the uninsured rate for people under age 65 fell from 11.1 percent in 2019 to 10.5 percent in 2021. Gains in coverage were largest in several states with recent Medicaid expansions, including Maine (-3.2 percentage points) and Idaho (-2.1 percentage points).
• Larger gains in coverage occurred for demographic groups with higher historical uninsured rates, including adults ages 19-34 and 35-49 (both declined by 1.0 percentage point), Latino individuals (-1.0 percentage point), American Indian / Alaska Native individuals (-0.9 percentage points), and non-English speaking adults (-1.5 percentage points).
• The decline in the uninsured rate was largest for those with household incomes between 100 and 250 percent of the Federal Poverty Level (FPL).
• Coverage gains varied widely across Asian American and Native Hawaiian/Pacific Islander (AANHPI) and Latino communities; disaggregating data for these groups reveals important differences in coverage patterns.
• Federal policies – such as an enhanced Marketplace access to a Special Enrollment Period in 2021, expanded and enhanced premium tax credits under the American Rescue Plan, enhanced funding for Marketplace outreach and enrollment assistance, and the Medicaid continuous enrollment provision during the COVID public health emergency – likely contributed to gains in health coverage since 2019, particularly among low-income populations and communities of color.

The full HHS report, “Changes in Health Insurance Coverage, 2019-2021: Geographic and Demographic Patterns in the Uninsured Rate”, is available at https://aspe.hhs.gov/reports/changes-health-insurance-coverage-2019-2021.