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Health insurance coverage is the comprehensive coverage on the means of financing an individuals healthcare expenses as presented in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC). The coverage plan protects one against various medical conditions such as chronic diseases, serious illnesses, disablement, physical injuries, and death. Today, medical treatments are very expensive if one needs quality medical care. With several players in the insurance sector, one has the liberty to opt for pocket-friendly policies and those that fulfill their requirements. While many individuals possess private health insurance, others may obtain coverage programs the state and federal governments offer. Private coverage includes employment-based plans, which are provided through an employer or a union, direct purchase is directly through a marketplace or federal and TRICARE.
Public coverage includes Medicare, Medicaid, the Civilian Health and Medical Program of the Department of Veterans Affairs, and care provided by the Department of Veterans Affairs (AV) and the military. The health insurance coverage rate has evolved due to various factors such as shifts in demographics in the composition of the population and changes in policies that affect access to care (Sommers et al., 2017). This paper covers the insurance status and access to health services in my current residence, Florida, with the coverage year choice being 2019, which is the recent year posted on the website.
Key Insurance Findings of Florida
Primary payers are the health insurers that pay first for the healthcare or the claim, regardless of other insurance coverage the insured may possess. The primary payers in Florida include Medicare which involves those covered by Medicare Advantage and Medicare. Medicaid payers include individuals covered by Medicaid, Childrens Health Insurance Plan, Medical Assistance, or any other government assistance plan for individuals with low income and the disabled. Employer-based insurance includes those covered by their employers or union as dependent or policyholders (Berchick et al., 2018). Non-Group insurance includes those covered policies purchased directly from an insurance company. Another payer is the military which includes the people covered by the Veterans Administration and the military.
Percentage of the Coverage of the Primary Payers
Private health insurance coverage continues to be more prevalent compared to government coverage. Employer-based insurance covers 40.3% of the population for some or all of the calendar year (Health insurance coverage of the total population). The second most common coverage was Medicare which covered 18% of the population (Health insurance coverage of the total population). Medicare covered 17.4 %, followed by non-group insurance, which covered 9.5% of the Florida population. The lowest coverage distribution was the military, covering 1.7% of the population (Health insurance coverage of the total population).
The Uninsured Population in Florida
The uninsured rate represents the population not covered by public or private health insurance. The uninsured population in Florida in 2019 was 13.1% (Health insurance coverage of the total population). The populations that are highly affected and possess the higher uninsured rate include adults compared to children and seniors, specifically adults who are 65 years and older (Sommers et al., 2017). Hispanic adults are more uninsured compared to members of other ethnic and racial groups (Sommers et al., 2017). Ethnic minorities make up a large portion of the uninsured, with the link between cultural and language differences that horn in the US and the immigrants. The ethnic minorities face racial prejudices and inequalities that may affect their employment status, work mediocre jobs and experience lower living standards. Individuals with low-income levels are recorded below the federal poverty level. Additionally, among adults insured all year, 29 percent of Floridians were underinsured (Health insurance coverage of the total population). People in employer plans dominate the state underinsured estimates.
Trend Graph of the Public and Private Payers and the Uninsured
There have been changes in insurance rates but a general increasing overall trend. Employer-based insurance in Florida was at a high rate in 2008 at 46.0% and then decreased to 38.3% in 2016; the rate was 39.7% in 2017, 40.0% in 2018, and 40.3% in 2019. There has been a decreasing trend over the last four years, from 19.0% in 2016, 18.6% in 2017, and 18.0% in 2018 to 17.4% in 2019 (Health insurance coverage of the total population). The graph shows a generally increasing trend for Medicare since 2008 at 14.0% and continues over the last four years with 17.2% in both 2016 and 2017, 17.4% in 2018 to 18.0% in 2019. The number of people Insured by Medicaid has generally increased since 2008.
The non-group distribution was low from 2018 at 6.4% till 2013, then the percentage shot from 2014(8.2%) and 2015(10.2%). The rate experienced a slight decrease from 10.1% in 2016, 2017, and 2018 had 9.7%, then decreased to 9.5% in 2019. Additionally, military coverage does not have major changes over the year. The rate was 1.8% in 2008. Slightly higher rates were recorded in 2015 (2.1%), then there is a slight decreasing rate with 1.9% in both 2016 and 2017, 1.8% in 2018, and 1.7% in 2019. The general trend of the uninsured has decreased since 2008 (20.9%) over the cause of the following years to 12.5% in 2016 (Health insurance coverage of the total population). The rate, however, experienced a slight increase with 12.9% in 2017, 13.2% in 2018, and 13.1% in 2019.
The Affordable Care Act (ACA) was designed for the significance of extending coverage to more American, ideally to cover all Americans. The ACA has increased insurance coverage using premium subsidies for private coverage, an individual mandate, and Medicaid expansion (Frean et al., 2017). Before the ACA was implemented, Florida was a state with among the highest rate of uninsured. Following implementation, the rate reportedly dropped from around 20% in 2016 to 13.1% in 2019 (Health insurance coverage of the total population). This rate, however, is still higher than the national average for the uninsured population. Florida has a large percentage of enrollees on the government exchange, indicating that a lower percentage of the state can gain healthcare through their employer. This may happen even when employees are not qualified for Medicaid and Medicare. It was identified that fewer people from Florida enrolled in ACA coverage in 2018 compared to 2017, which may be due to the administrations less aggressive advertising of healthcare exchange. The current administration had vowed to repeal or gut the bill. This situation has since largely resulted in the ACA languishing rather than aggressively attempting to repeal it, even though several legal changes have undercut its provisions.
Initially, there was fear of skyrocketing cost premiums in Florida due to the administration of Triumphs refusal to fund the cost-saving reduction of the ACA insurance plan. For eligible individuals, the cost-sharing reduction subsidies lower the total amount paid for the medical service annually. One of the major challenges of the ACA was that the plans deductibles were very high and not considered worthwhile or most customers to purchase the coverage on a cost-benefit basis (Pullman Regional Hospital, 2017). The trend is changing and is not yet to the good based on the high rate of uninsured in Florida. The state should address the challenge of the insurance plans accessibility to its people. Florida is part of the ACA but does not offer expansion that supports low-income under Medicaid. If the state supports the provision regarding the health care reform, more people will have access to quality medical care.
References
Berchick, E. R., Barnett, J. C., & Upton, R. D. (2018). Health Insurance Coverage in the United States, 2017: Current Population Reports. US Department of Commerce, US Census Bureau.
Frean, M., Gruber, J., & Sommers, B. D. (2017). Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. Journal of Health Economics, 53, 72-86.
Health insurance coverage of the total population. (2021). KFF.
Pullman Regional Hospital. (2017). Healthcare finance 101 with Steve Febus [Video]. Youtube.
Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and healthwhat the recent evidence tells us. New England Journal of Medicine, 377(6), 586-593.
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