Census Bureau: 'Health Insurance Coverage by Race & Hispanic Origin – 2021'
Here are excerpts:
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INTRODUCTION
Health insurance status and coverage type are shaped by a variety of factors, including demographic characteristics, economic conditions, and state and federal policies that affect access to care. Yet, health care coverage - whether people have health insurance as well as the type of coverage they hold - varies across groups, such as by race and Hispanic origin. Disparities in health insurance coverage status and type across race and Hispanic origin may reflect differences in the social determinants of health, which include occupation, income, poverty status, and other measures of economic stability, as well as where people live and their neighborhood context./1
Understanding differences in health insurance coverage by race and Hispanic origin may help inform measures to increase equity in access to care, health, and well-being.
Disparities in health coverage by race persist despite data showing that differences in the uninsured rate between White, non-Hispanic individuals under the age of 65 and members of other race and Hispanic origin groups narrowed after many provisions of the Patient Protection and Affordable Care Act (ACA) were implemented in 2014./2
This brief uses 2021
The large sample size of the ACS allows for an examination of types of coverage, including private and public coverage, and the relationship between types of coverage and related characteristics for small population groups. Examining these differences highlights the extent to which racial and Hispanic origin differences in health coverage persist across characteristics. Further, exploring differences by selected characteristics underscores differences in health coverage within race and Hispanic origin.
KEY FINDINGS
* The uninsured rate across race and Hispanic origin groups presented in this report ranged from 5.7 percent for White, non-Hispanic people to 18.8 percent for those identifying as American Indian and Alaska Native, non-Hispanic./4 Hispanic or Latino people had among the highest uninsured rate in the nation at 17.7 percent.
* Private coverage rates ranged from 43.1 percent among American Indian and Alaska Native, non-Hispanic people to about 74.2 percent for White, non-Hispanic people./5 Lower rates of private coverage for some groups were partly offset by higher rates of public coverage for these groups.
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1
2
3 The
4 There was no statistical difference in the uninsured rate for White, non-Hispanic and Asian, non-Hispanic people in 2021.
5 There was no statistical difference in the private coverage rate for White, non-Hispanic and Asian, non-Hispanic people in 2021.
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* For children under the age of 19 and adults aged 19 to 64, people identifying as American Indian and Alaska Native, non-Hispanic had among the highest uninsured rates./6 Asian, non-Hispanic individuals had among the lowest uninsured rates in all age groups except for adults aged 65 and older./7
* For all race and Hispanic origin groups, rates of public coverage declined as the income-to-poverty ratio increased. Although Hispanic children had higher rates of public coverage than the national average across all income-to-poverty groups, the public coverage rate for Hispanic adults living in poverty (43.5 percent) was lower than the national public coverage rate for adults aged 19 to 64 in poverty (49.9 percent).
* Across race and Hispanic origin groups, children living with their parents had the highest rates of private coverage. However, fewer than half of Black, non-Hispanic (45.0 percent); American Indian and Alaska Native, non-Hispanic (40.3 percent); and Hispanic (44.7 percent) children living with their parents were covered by private health insurance.
* White, non-Hispanic and Asian, non-Hispanic working-age adults had among the highest rates of private coverage across employment categories. The private coverage rate for Asian, non-Hispanic adults (65.3 percent) who were not in the labor force was higher than the private coverage rate and
In this brief, the race and Hispanic origin categories examined are mutually exclusive and include people identifying as American Indian and Alaska Native alone, not Hispanic or Latino (American Indian and Alaska Native, non-Hispanic); Asian alone, not Hispanic or Latino (Asian, non-Hispanic); Black or
HEALTH INSURANCE COVERAGE STATUS BY RACE AND HISPANIC ORIGIN
In 2021, about 8.6 percent of people were uninsured at the time of the ACS interview. However, there were differences in coverage by race and Hispanic origin.
Across race and Hispanic origin, the percentage of people who were uninsured ranged from 5.7 percent to 18.8 percent (Figure 1). White, non-Hispanic people and Asian, non-Hispanic people had among the lowest uninsured rates. Hispanic people and those identifying as American Indian and Alaska Native, non-Hispanic had among the highest uninsured rates in the nation at 17.7 percent and 18.8 percent, respectively./8
THE UNINSURED RATE BY
Age is associated with the likelihood that a person has health insurance coverage. Adults aged 65 and older and children under 19 years are more likely to have health insurance coverage than those aged 19 to 64, in part because their age makes them eligible for certain public health insurance programs. Medicare provides health coverage benefits for most adults aged 65 and older. Children and young adults may receive coverage through a parent or guardian's plan until the age of 26, and children under the age of 19 may qualify for coverage through Medicaid or the
In 2021, among all people, adults aged 65 and older had the lowest uninsured rate (0.8 percent), followed by children under the age of 19 (5.4 percent) and adults aged 19 to 64 (12.2 percent) (Figure 2). Within each race and Hispanic origin group, people aged 65 and over had the lowest uninsured rate, while those aged 19 to 64 had the highest uninsured rate (Figure 2 and Table A-1).
The uninsured rate among children under the age of 19 ranged from 3.6 percent to 13.3 percent. The groups with uninsured rates at the lower end of the distribution were Asian, non-Hispanic children (3.6 percent) and Multiracial, non-Hispanic children (3.8 percent)./10
American Indian and Alaska Native, non-Hispanic children had the highest uninsured rate (13.3 percent).
Differences in health coverage by race and Hispanic origin existed for working-age adults aged 19 to 64, ranging from 7.2 percent for Asian, non-Hispanic adults to 24.8 percent for American Indian and Alaska Native, non-Hispanic adults. The uninsured rate for Some Other Race, non-Hispanic adults (13.5 percent); Black, non-Hispanic adults (13.5 percent); Hispanic adults (24.6 percent); and American Indian and Alaska Native, non-Hispanic adults exceeded the average uninsured rate for this age group (12.2 percent), while the uninsured rate for Asian, non-Hispanic adults; White, non-Hispanic adults (8.2 percent); and Multiracial, non-Hispanic adults (11.2 percent) was below the average./11
Adults aged 65 and older in each race and Hispanic origin group had the lowest uninsured rate across age groups as most older adults are eligible for coverage through Medicare, yet there were still differences in coverage by race and Hispanic origin. For those aged 65 and older, the uninsured rate ranged from 0.3 percent for White, non-Hispanic adults to 3.6 percent for Hispanic adults in 2021./12
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6 There was no statistical difference in the uninsured rate between American Indian and Alaska Native, non-Hispanic adults aged 19 to 64 and Hispanic adults aged 19 to 64 in 2021.
7 There was no statistical difference in the uninsured rate for Asian, non-Hispanic and Multiracial, non-Hispanic children in 2021.
8 The uninsured rate for Hispanic people was lower than the uninsured rate for those identifying as American Indian and Alaska Native, non-Hispanic.
9 CHIP is a public program that provides health insurance to children in families with incomes above the Medicaid eligibility threshold who cannot afford private health insurance coverage.
10 There was no statistical difference between the uninsured rate for Asian, non-Hispanic children and Multiracial, non-Hispanic children.
11 There was no statistical difference in the uninsured rate for all adults aged 19 to 64 and those identifying as Native Hawaiian and Pacific Islander, non-Hispanic.
12 The uninsured rate for Hispanic adults aged 65 and older was not statistically different from the uninsured rate for adults aged 65 and older identifying as Some Other Race, non-Hispanic.
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Figure 1. Percentage of People without Wealth Insurance Coverage by Race and Hispanic Origin: 2021
Note: Hispanic or Latino includes people identifying as any race. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the
Source:
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PUBLIC HEALTH INSURANCE COVERAGE BY RACE AND HISPANIC ORIGIN
Socioeconomic status, reflected in part through income and poverty status, is an important social determinant of health that shapes access to health coverage and care. Public insurance programs are designed to provide a "safety net" for individuals who have difficulty affording private coverage. Children and adults under the age of 65 with low incomes may be eligible to obtain public coverage through Medicaid (and for children under the age of 19, CHIP), and veterans can access public coverage through the
In 2021, 39.5 percent of children under the age of 19 held public coverage at the time of interview. Among children under the age of 19, 58.7 percent of Black, non-Hispanic children and American Indian and Alaska Native, non-Hispanic children held public coverage, followed by Hispanic children (53.7 percent) and those identifying as Native Hawaiian and Pacific Islander, non-Hispanic (50.8 percent)./13
White, non-Hispanic and Asian, non-Hispanic children had among the lowest public coverage rates at about 28.1 percent and 28.0 percent, respectively (Figure 3)./14
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13 The public coverage rate for children identifying as Black, non-Hispanic or American Indian and Alaska Native, non-Hispanic did not statistically differ in 2021. The public coverage rate for Native Hawaiian and Pacific Islander, non-Hispanic children was not statistically different from the public coverage rate for Hispanic children.
14 The public coverage rates for Some Other Race, non-Hispanic children and Multiracial, non-Hispanic children were not statistically different from one another, at 38.5 percent and 38.1 percent, respectively.
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Figure 2. Percentage of People Without Health Insurance Coverage by
Note: Hispanic or Latino includes people identifying of any race. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the
Source:
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Figure 3. Percentage of People With Public Health Coverage by
Note: Hispanic or Latino includes people identifying of any race. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the
Source:
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In part, these differences in public health coverage reflect differences in the income-to-poverty distribution of children under the age of 19 by race and Hispanic origin. Children in families with income at or above 400 percent of the poverty level are less likely to be eligible to receive coverage through Medicaid and CHIP. The percentage of Asian, non-Hispanic children living in families with income at or above 400 percent of poverty was the highest (50.6 percent) among race and Hispanic origin groups, followed by White, above 400 percent of poverty - White, non-Hispanic (52.4 percent) and Asian, non-Hispanic (56.5 percent) - had lower public coverage rates, compared with adults in other race and Hispanic origin groups (Table A-2).
Public Coverage for Children Under the Age of 19 by Income-to-Poverty Ratio and Race and Hispanic Origin
Examining public coverage by poverty status reveals differences across and within racial groups for children under the age of 19 and for adults aged 19 to 64. Within race, rates of public coverage decrease as the income-to-poverty ratio (IPR) increases for both children under the age of 19 and adults aged 19 to 64. For each race and Hispanic origin group, public coverage rates are highest for those in poverty, and lowest for those with family income at or above 400 percent of poverty.
Among children in poverty, the difference in public coverage across groups was 15.3 percentage points. Black, non-Hispanic children in poverty had the highest public coverage rate among all racial groups (87.2 percent). Native Hawaiian and Pacific Islander, non-Hispanic children living in poverty had among the lowest rate of public coverage at 71.9 percent (Figure 4 and Table A-2)./15
Among children with family income 100 to 399 percent of poverty, public coverage rates ranged from 35.7 percent for White, non-Hispanic children to 55.0 percent among Black, non-Hispanic children, a 19.3 percentage-point difference./16
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15 In 2021, the public coverage rate for Native Hawaiian and Pacific Islander, non-Hispanic children in poverty was not statistically different from public coverage rates for Asian, non-Hispanic children in poverty; White, non-Hispanic children in poverty; or children in poverty identifying as Some Other Race, non-Hispanic.
16 Public health insurance coverage rates for American Indian and Alaska Native, non-Hispanic children (53.9 percent) and Hispanic children (54.7 percent) with family income 100 to 399 percent of poverty were not statistically different from the public coverage rate for Black, non-Hispanic children in this income-to-poverty ratio group.
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Figure 4. Percentage of Children Under the Age of 19 With Public Coverage by Income-to-Poverty Ratio, Race, and Hispanic Origin: 2021
Note: Hispanic or Latino includes people identifying of any race. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the
Source:
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Among children with family incomes 400 percent or more above poverty, public health coverage rates ranged from 7.7 percent for White, non-Hispanic children to 32.5 percent for children identifying as Native Hawaiian and Pacific Islander, non-Hispanic - a difference of 24.8 percentage points./17
White, non-Hispanic and Asian, non-Hispanic (8.0 percent) children in families with incomes at or above 400 percent of poverty had public coverage rates less than the group average of 10.0 percent, while Black, non-Hispanic children (19.1 percent); American Indian and Alaska Native, non-Hispanic children (21.4 percent); Hispanic children (16.6 percent); and Native Hawaiian and Pacific Islander, non-Hispanic children had public coverage rates above this average./18
Public Health Insurance Coverage for Adults Aged 19 to 64 by Income-to-Poverty Ratio and Race and Hispanic Origin
Differences in public coverage by race, Hispanic origin, and income-to-poverty ratio group were also apparent among adults aged 19 to 64. Among adults in poverty, public coverage rates ranged from 38.4 percent for Asian, non-Hispanic adults to 59.3 percent for Black, non-Hispanic adults, a difference of 20.9 percentage points./19
The difference in public coverage by race and Hispanic origin was 9.2 percentage points for adults aged 19 to 64 with incomes 100 to 399 percent of poverty and 8.8 percentage points for adults aged 19 to 64 with incomes at or above 400 percent of poverty (Figure 5 and Table A-2)./20
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17 There was no statistical difference in public coverage rates between White, non-Hispanic children and Asian, non-Hispanic children in families at or above 400 percent of poverty.
18 The percentage of American Indian and Alaska Native, non-Hispanic children in families at or above 400 percent of poverty is not significantly different from Black, non-Hispanic children (19.1 percent) in this group. Public coverage rates for White, non-Hispanic and Asian, non-Hispanic children with family income at or above 400 percent of poverty were not statistically different.
19 There was no statistical difference in public coverage among adults aged 19 to 64 in poverty who identified as Black, non-Hispanic and American Indian and Alaska Native, non-Hispanic.
20 There was no statistical difference in public coverage among adults aged 19 to 64 with income at or above 400 percent of poverty who identified as Native Hawaiian and Pacific Islander, non-Hispanic or American Indian and Alaska Native, non-Hispanic.
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Figure 5. Percentage of Adults Aged 19 to 64 With Public Coverage by Income-to-Poverty Ratio, Race, and Hispanic Origin: 2021
Note: Hispanic or Latino includes people identifying of any race. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the
Source:
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Among adults aged 19 to 64 in poverty, Asian, non-Hispanic adults had the lowest public coverage rate (38.4 percent), followed by those identifying as Some Other Race, non-Hispanic (42.6 percent) and Hispanic adults (43.5 percent)./21 Multiracial, non-Hispanic (54.7 percent); American Indian and Alaska Native, non-Hispanic (57.4 percent); and Black, non-Hispanic (59.3 percent) adults aged 19 to 64 in poverty had public coverage rates higher than the average for adults aged 19 to 64 in poverty (49.9 percent).
Among adults aged 19 to 64 with incomes 100 to 399 percent of the poverty level, those identifying as American Indian and Alaska Native, non-Hispanic had the highest public coverage rate (31.0 percent), while White, non-Hispanic adults had the lowest at 21.8 percent.
Racial differences in public coverage also remain among adults aged 19 to 64 with income at or above 400 percent of poverty. For example, Asian, non-Hispanic adults (6.0 percent) had the lowest public coverage rate among race and Hispanic origin groups, while Native Hawaiian and Pacific Islander, non-Hispanic adults had among the highest public health coverage rate at 14.7 percent./22
PRIVATE HEALTH INSURANCE COVERAGE BY RACE AND HISPANIC ORIGIN
Most people in
In 2021, 60.5 percent of children had private health insurance coverage. Asian, non-Hispanic children (73.7 percent) and White, non-Hispanic children (73.1 percent) had among the highest rates of private coverage./23 About 43 percent of Black, non-Hispanic children and Hispanic children held private coverage in 2021, while American Indian and Alaska Native, non-Hispanic children had the lowest private coverage rate (34.3 percent) (Figure 6 and Table A-2)./24 In 2021, 72.7 percent of adults aged 19 to 64 had private health insurance coverage (Figure 6), masking differences in coverage by race and Hispanic origin within this broad age group. Asian, non-Hispanic adults aged 19 to 64 were the most likely to hold private coverage (80.7 percent), followed by White, non-Hispanic adults (79.5 percent). American Indian and Alaska Native, non-Hispanic adults (47.5 percent) had the lowest rate of private coverage.
Private Health Insurance Coverage for Children Under the Age of 19 by Race and Hispanic Origin and Living Arrangements
Children's living arrangements may influence their health insurance coverage type. Children living with one or both parents may receive dependent coverage through a parent or guardian's private health insurance plan up to the age of 26. Although a child may be covered as a dependent on a nonresident parent's health insurance plan, children living with other relatives or with nonrelatives may be less likely to hold private coverage if the relative or nonrelative is not a legal guardian.
Most children under the age of 19 (87.7 percent) lived in their parent's household. The percentage of children living in their parent's household ranged from about 72 percent for Native Hawaiian and Pacific Islander, non-Hispanic children and American Indian and Alaska Native, non-Hispanic children to about 91.6 percent for Asian, non-Hispanic children./25 About one-quarter of American Indian and Alaska Native, non-Hispanic children and Native Hawaiian and Pacific Islander, non-Hispanic children lived in another relative's household or with a spouse (Table A-3).
Children under the age of 19 living in their parent's household were most likely to hold private coverage (63.7 percent), compared with those living with other relatives (35.6 percent) or with nonrelatives (33.0 percent). However, there were differences in private coverage within these groups (Figure 7).
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21 There was no statistical difference in public coverage rates between adults aged 19 to 64 in poverty identifying as Hispanic or as Some Other Race, non-Hispanic.
22 The percentage of public health coverage for Native Hawaiian and Pacific Islander, non-Hispanic adults aged 19 to 64 living at or above 400 percent of poverty did not statistically differ from the public health coverage rate for American Indian and Alaska Native, non-Hispanic working-age adults (13.4 percent) in this income-to-poverty ratio group.
23 The private coverage rate for Asian, non-Hispanic children was higher than the private coverage rate for White, non-Hispanic children in 2021.
24 The private coverage rate for Black, non-Hispanic children was not statistically different from the private coverage rate for Hispanic children.
25 The percentage of children living in their parent's household between Native Hawaiian and Pacific Islander, non-Hispanic children and American Indian and Alaska Native, non-Hispanic children was not statistically different.
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For example, private coverage rates for children living in their parent's household were highest among White, non-Hispanic children (76.0 percent) and Asian, non-Hispanic children (75.5 percent), and lowest among American Indian and Alaska Native, non-Hispanic children (40.3 percent)./26
About 45 percent of Black, non-Hispanic children and Hispanic children living in their parent's household held private coverage./27 Among children living with other relatives, Asian, non-Hispanic children had among the highest rates of private coverage (51.7 percent), and children identifying as American Indian and Alaska Native, non-Hispanic had the lowest private coverage rate (17.9 percent)./28 Private coverage rates were lower than the national average (35.6 percent) for Black, non-Hispanic children (32.0 percent); Hispanic children (30.4 percent); and American Indian and Alaska Native, non-Hispanic children living with other relatives.
Finally, about 1.5 million children (1.9 percent of all children living in households) lived with nonrelatives or lived alone. Among children living with nonrelatives or living alone, Asian, non-Hispanic children had the highest private coverage rate at 47.5 percent, followed by White, non-Hispanic children at 38.8 percent. American Indian and Alaska Native, non-Hispanic children had among the lowest private coverage rate (17.1 percent)./29
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26 The private coverage rates for Asian, non-Hispanic children and White, non-Hispanic children living in their parent's household in 2021 were not statistically different.
27 The private coverage rates for Black, non-Hispanic children and Hispanic children living in their parent's household in 2021 were not statistically different.
28 The private coverage rate for Asian, non-Hispanic children living with other relatives was not statistically different from the private coverage rate for Native Hawaiian and Pacific Islander, non-Hispanic children living with other relatives (43.8 percent).
29 The private coverage rate for American Indian and Alaska Native non-Hispanic children living with nonrelatives or living alone was not statistically different from the private coverage rates for Native Hawaiian and Pacific Islander, non-Hispanic children or children identifying as Some Other Race, non-Hispanic living with nonrelatives or living alone.
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Figure 6. Percentage of People With Private Health Coverage by
Note: Hispanic or Latino includes people identifying of any race.
For information on confidentiality protection, sampling error, nonsampling error, and definitions in the
Source:
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Private Health Insurance Coverage for Working-Age Adults Aged 19 to 64 by Race and Hispanic Origin and Employment Status
Differences in coverage by race and Hispanic origin may reflect differences in the social determinants of health that shape health outcomes, including whether a person has health insurance coverage as well as the type of health coverage that they hold. For example, many people receive coverage through their own or through a family member's employer. Therefore, whether or not someone is employed and the type of job they have will affect whether they and their dependents are eligible for and have insurance through a private employer-sponsored plan.
Thus, differences in employment status and occupation by race and Hispanic origin may result in differences in private coverage. Indeed, the percentage of adults aged 19 to 64 who were employed ranged from 59.6 percent for American Indian and Alaska Native, non-Hispanic adults to 75.2 percent for White, non-Hispanic adults (Table A-4).
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Figure 7. Percentage of Children Under the Age of 19 With Private Coverage by Living Arrangement, Race, and Hispanic Origin: 2021
Note: Hispanic or Latino includes people identifying of any race. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the
Source:
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Examining private coverage rates by employment status highlights differences in health insurance coverage across and within race and Hispanic origin groups.
For example, 81.3 percent of employed adults aged 19 to 64 held private coverage, compared with their counterparts who were unemployed (41.4 percent) or not in the labor force (50.3 percent)./30 This pattern held across all race and Hispanic origin groups. That is, employed adults aged 19 to 64 had the highest private coverage rates, while those who were unemployed had the lowest private coverage rates for each race and Hispanic origin group (Figure 8).
For adults aged 19 to 64 who were employed, White, non-Hispanic and Asian, non-Hispanic adults had among the highest rates of private coverage, at 87.1 percent and 86.8 percent, respectively, while private coverage rates were the lowest among Hispanic adults (65.1 percent) and American Indian and Alaska Native, non-Hispanic adults (63.7 percent)./31
About 53.7 percent of unemployed Asian, non-Hispanic adults aged 19 to 64 held private coverage, followed by White, non-Hispanic adults (48.5 percent). About 33.0 percent of unemployed Black, non-Hispanic adults and 32.2 percent of Hispanic working-age adults held private coverage in 2021./32 Among the unemployed, American Indian and Alaska Native, non-Hispanic adults had the lowest private coverage rate at 17.0 percent.
Working-age adults who are not in the labor force may have private coverage on someone else's plan or may purchase private coverage directly. About 65.3 percent of Asian, non-Hispanic adults who were not working held private coverage. Among nonworking adults aged 19 to 64, White, non-Hispanic adults had the next highest private coverage rate (57.8 percent). About 35.8 percent of Hispanic adults and 34.8 percent of Black, non-Hispanic adults who were not working held private coverage. About one in four working-age adults identifying as American Indian and Alaska Native, non-Hispanic (25.1 percent) who were not in the labor force were covered by a private health insurance plan.
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30 All civilians 16 years and over are classified as "unemployed" if they (1) were neither "at work" nor "with a job but not at work" during the reference week, and (2) were actively looking for work during the last 4 weeks, and (3) were available to start a job. Also included as unemployed are civilians who did not work at all during the reference week, were waiting to be called back to a job from which they had been laid off and were available for work except for temporary illness. The category "Not in the Labor Force" includes all people 16 years old and over who are not classified as members of the labor force. This category consists mainly of students, homemakers, retired workers, seasonal workers interviewed in an off season who were not looking for work, institutionalized people, and people doing only incidental unpaid family work (less than 15 hours during the reference week). For more information about labor force status, refer to
31 The private coverage rates among employed adults identifying as White, non-Hispanic and Asian, non-Hispanic were statistically different in 2021. Private coverage rates among employed adults identifying as Hispanic and American Indian and Alaska Native, non-Hispanic were statistically different in 2021.
32 The percentage of private coverage for unemployed Black, non-Hispanic and Hispanic working-age adults was not statistically different.
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WHAT IS HEALTH INSURANCE COVERAGE?
This brief presents estimates of health insurance coverage using data from the 2021
For reporting purposes, the ACS broadly classifies health insurance coverage as private insurance or public insurance. The ACS defines private health insurance as a plan provided through an employer or a union, coverage purchased directly by an individual from an insurance company or through an exchange (such as healthcare.gov), or coverage through TRICARE. Public insurance coverage includes federal programs (such as Medicare, Medicaid, and the
In the ACS, people are considered "insured" if they were covered by any of these types of health insurance at time of interview. People are considered uninsured if they were not covered by any of these types of health insurance at time of interview or if they only had coverage through the
* Comprehensive health insurance covers basic health care needs. This definition excludes single-service plans, such as accident, disability, dental, vision, or prescription medicine plans.
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SUMMARY
This brief examined the differences in health insurance coverage by race and Hispanic origin. Lower uninsured rates for White, non-Hispanic and Asian, non-Hispanic people compared with other race and Hispanic origin groups are driven in part by higher rates of private coverage among these groups. Although higher rates of safety net coverage through public programs provide access to health care for American Indian and Alaska Native, non-Hispanic people; Native Hawaiian and Pacific Islander, non-Hispanic people; and Hispanic people across all income-to-poverty groups, disparities in coverage persist as these groups have among the highest uninsured rates.
Racial differences in health insurance coverage persisted across age and selected characteristics and reflect disparities in social determinants of health, such as income and poverty status as well as employment. Yet, this brief also highlights racial differences among people within employment status or income-to-poverty ratio groups. For example, although private coverage rates were higher among employed adults aged 19 to 64 compared with the unemployed and nonworkers, employed White, non-Hispanic and Asian, non-Hispanic adults had the highest rates of private coverage, while Hispanic adults and those identifying as American Indian and Alaska Native, non-Hispanic had private coverage rates more than 20 percentage points lower. Indeed, employed American Indian and Alaska Native, non-Hispanic working-age adults had private coverage rates that were lower than Asian, non-Hispanic adults who were not in the labor force. Describing the differences in health coverage may inform measures to increase equity in access to care, health, and well-being.
SOURCE AND ACCURACY
The data presented in this brief are based on the ACS sample interviewed from
All comparative statements in this brief have undergone statistical testing, and comparisons are significant at the 90 percent confidence level unless otherwise noted. In addition to sampling error, nonsampling error may be introduced during any of the operations used to collect and process survey data such as editing, reviewing, or keying data from questionnaires.
For more information on sampling and estimation methods, confidentiality protection, and sampling and nonsampling errors, refer to the 2021 ACS Accuracy of the Data document located at <https://www2.census.gov/programs-surveys/acs/techdocs/accuracy/ACS_Accuracy_of_Data_2021.pdf>.
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HOW RACE AND HISPANIC ORIGIN ARE DEFINED IN THIS
BRIEF
The 1997 OMB standards emphasize that people of Hispanic or Latino origin (the terms "Hispanic and Latino") may be of any race. In many
In this brief, we cross-tabulate the race groups with the Hispanic and Latino origin category to present eight mutually exclusive Hispanic origin by race groups. Cross-tabulating the race and Hispanic origin categories yields a relatively small Some Other Race alone, non-Hispanic population.
The following groups are used in this brief:
* American Indian and Alaska Native alone, not Hispanic or Latino (American Indian and Alaska Native, non-Hispanic).
* Asian alone, not Hispanic or Latino (Asian, non-Hispanic).
* Black or
* Hispanic or Latino (Hispanic).
* Native Hawaiian and Other Pacific Islander alone, not Hispanic or Latino (Native Hawaiian and Pacific Islander, non-Hispanic).
* Some Other Race alone, not Hispanic or Latino (Some Other Race, non-Hispanic).
* Two or More Races, not Hispanic or Latino (Multiracial, non-Hispanic).
* White alone, not Hispanic or Latino (White, non-Hispanic).
* For the text of the race and Hispanic origin questions, refer to Appendix A: Questions 5 and 6 on the
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Table A-1. Percentage of People Without Health Insurance Coverage, With Private Health Insurance Coverage, and With Public Health Insurance Coverage by Race, Hispanic Origin, and
The report is posted at: https://www.census.gov/content/dam/Census/library/publications/2022/acs/acsbr-012.pdf
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