7% in state lack health insurance Census data: Percentage up slightly over 2020, but disparities remain

In Illinois last year, 7% of residents - about 875,000 people - lacked health insurance coverage, according to U.S. Census data released Thursday.

That number was up slightly from about 6.8% in 2020, though the margin of error this year was 0.2.

Nationally, about 8.6% of people were uninsured last year, according to data from the Census' American Community Survey.

It's possible Illinois' uninsured rate held relatively steady because of federal protections put in place during the pandemic that were meant to make it easier for people to hold on to their coverage, said Stephani Becker, associate director of health care justice at the Chicago-based Shriver Center on Poverty Law.

During the pandemic, the federal government has prohibited states that accepted additional Medicaid funding from kicking people off of Medicaid, which is state and federally funded health insurance for low-income people. In pre-pandemic times, Medicaid coverage had to be renewed periodically, and some people would lose it because they no longer qualified, and others because of administrative issues, such as not sending in paperwork.

Also, in 2021, President Joe Biden signed a bill into law that increased and expanded subsidies that offset the monthly costs of health insurance purchased through the Affordable Care Act exchange at healthcare.gov. Those enhanced subsidies were recently extended through 2025, with the signing of the Inflation Reduction Act.

"Both of those things together are huge policy choices that this administration has taken that allow people to stay on their current health coverage through Medicaid and get more affordable health coverage through the (Affordable Care Act) marketplace," Becker said.

Disparities, however, remain.

The percentages of Black and Latino people in Illinois without insurance were much higher than the percentage of white people lacking coverage. About 7.9% of Black Illinois residents and 15.8% of Hispanic or Latino people didn't have insurance in 2021, compared with only 4.3% of white people.

"That's a legacy of systemic inequalities in health insurance in Illinois and everywhere across the country," Becker said. Also, some people don't have the option of getting insurance through their employers, she said.

In 2021, about 59% of Illinois residents got health insurance through their employers and about 35% got insurance through public programs, such as Medicare or Medicaid, according to the new Census report.

Though the number of people on Medicaid grew nationally last year, the percentage of people with private insurance, such as through their employers, dropped, noted Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University's McCourt School of Public Policy. She said the cost of offering insurance has been rising for employers making it difficult for many to provide coverage or leading them to shift some of the growing costs onto workers, such as through higher premiums.

In Illinois, the percentage of people uninsured, by income, was highest among those who had household incomes of $25,000 to $49,999. About 10.8% of people in that income group in Illinois were uninsured.

That may be because people in that range may not qualify for Medicaid and don't realize they can likely get lower-cost coverage through the Affordable Care Act exchange because of subsidies, Becker said. Or, it's possible even low-cost exchange coverage is still too expensive for them, she said.

"I talk to a lot of people who worry. Health coverage is a continual worry for them," Becker said. "They've done the math and are making choices. They feel like it's a trade-off between that, food and gas ... Sometimes they don't know about the options out there."