For years, people have been forking out cash to get coverage. Several health insurance statistics reveal that projected healthcare costs will increase by 5.4% annually. That only implies that Americans should brace themselves for another yet-to-come inflation on health insurance costs.
The cost of health insurance in the United States can easily outpace its average annual GDP growth rate. It’s shocking, but true, given that the US has the most expensive health insurance in the world.
It’s no secret that healthcare expenditure in the country is going off the charts, and this problem is burning people out.
Why?
It’s because the effect of skyrocketing healthcare spending goes back to the citizens through health insurance premiums.
US health insurance is a well-documented topic, so we’ve compiled the latest stats and trends if you want to know more.
Intriguing Health Insurance Statistics (Editor’s Choice)
- US health insurance massively comprises 16.9% of its GDP
- Only 92% of Americans are insured
- In 2020, 11.5 million Americans purchased insurances in the state marketplace
- Healthcare fraud amounted to $300 billion
- In 2019, 26.1 million of the American population didn’t have health insurance
- The Latino population has the highest uninsured rate at 40%
- By 2028, predictions are that healthcare spending will reach $6.2 trillion
General Health Insurance Statistics
1. In 2019, 92% of Americans had health insurance.
(Census)
Despite being a powerful and wealthy nation, America doesn’t have universal health care. Even so, 92% of the people have managed to obtain insurance for themselves. Most got it through employer-sponsored benefits. Others purchased individual coverage and made it affordable by qualifying for government programs. Still, the percentage of Americans with health insurance is high, which only proves the people’s steady interest in it.
2. US health insurance is the most expensive worldwide; it accounts for 16.9% of the national GDP.
(Yahoo / Harvard)
Despite the generous healthcare spending, life expectancy in the country is wandering off than in other nations. Does this imply that the US needs to reform its healthcare system? Most Americans would probably say yes.
The United States health insurance statistics highlight the unbarred payments for MRIs, new drugs, organ transplants, and other new treatments as the catalyst that drives the nation’s healthcare spending off the grid. This outrageous expenditure reaches the payers in the form of expensive health insurance premiums.
Right after the US, Switzerland comes second as the country with the most expensive healthcare cost that comprises 12.2% of its GDP.
3. US health insurance statistics revealed that private coverage was more common, covering 68% of the people in 2019.
(Census)
When it comes to health insurance options, employment-based or employer-based insurance was more prevalent. That explains why private health insurance coverage was more popular than public coverage in the US. Numerically, a whopping 68% of the population had private health insurance, while only 34.1% had public health insurance programs.
4. The 2019 health care cost and insurance statistics revealed that the National Health Expenditures (NHE) rose to $3.8 trillion.
(CMS)
The latest stats divulged that the total healthcare spending in the US hit $3.8 trillion or $11,582 per person in 2019. Surprisingly, the colossal figure accounted for 17.7% of the country’s Gross Domestic Product (GDP) in that same year.
5. Private health insurance expenditures grew 3.7%, or equivalent to 31% of the entire NHE.
(CMS)
The ever-increasing medical or hospitalization costs, lifestyle changes, and inflations are the common-cited reasons that lead to the rise of healthcare spending.
Health insurance facts exposed that the private health insurance expenses in 2019 reached a jolting $1,195.1 billion or 31% of NHE.
6. In 2020, the average monthly cost for health insurance was $456 for an individual and $1152 for a family.
(eHealth)
Over 900 companies provided health insurance coverage in the United States in 2020, and most of them boast good coverage and budget-friendly plans. Although varying factors influence the end cost of insurance, such as income and age, the stats suggest that the average national price for an individual plan is only $456 and $1,152 for a family per month.
These amounts may be affordable for one person but not for the other, which creates a problem that leads to millions of uninsured. It seems that healthcare insurance affordability will remain a perpetual concern for Americans, despite the subsidies provided by more capable people.
7. In 2020, almost 11.5 million individuals purchased health insurance coverage through a state marketplace.
(Value Penguin)
Americans who are not offered employer-sponsored health insurance or are ineligible for Medicaid or Medicare can opt for purchasing individual coverage through a state marketplace.
Health insurance enrollment statistics reported that nearly 11.5 million Americans enrolled for individual health insurance coverage in 2020. While employers don’t split the cost with the policyholder, qualifying for state or federal assistance is an excellent option to afford individual health insurance premiums.
8. Government and law enforcement agencies estimated the financial losses for healthcare fraud to value more than $300 billion.
(NHCAA)
In the US, the prevalence of healthcare fraud is public knowledge. Federal authorities, including the FBI, have been closely monitoring Medicaid and Medicare fraud.
According to health insurance fraud statistics, multibillion health insurance claims resulted in a massive $3.6 trillion spending on health care. A small percentage, which would still correspond to billions of dollars, was turned into wicked profits due to dishonest filing and other fraudulent claims by some corrupt people.
The National Health Care Anti-Fraud Association (NHCAA) believed the financial losses relative to healthcare fraud constituted only 3% of the entire healthcare expenditure. The government and law enforcement agencies didn’t nod their heads in agreement to this as they estimated that the loss could be as high as 10% or more than $300 billion.
9. Minnesota had the most expensive family health insurance premiums in 2020 at $8,666 per year.
(Insider Monkey)
Americans pay between $5,815 to $8,666 for health insurance, depending on which state they live in. Health insurance cost statistics shared that Minnesotans pay for the most expensive family health coverage at $8,666. But state residents pay a reasonable amount of $6,781 for single health coverage – a silver lining for those who’d better get this kind of insurance.
The top five states with the most expensive family health insurance rates include South Dakota ($8,621), New Hampshire ($8,530), Arizona ($8,364), and New Jersey ($8,281).
10. In 2018, New Mexico had the lowest private health insurance coverage rate at only 54.3%; North Dakota had the highest at 79.7%.
(Census)
As many as 67.5% of Americans had private health insurance coverage in 2018. Of the 50 states, New Mexico had the lowest number of enrolled insurance owners under private coverage (54.3%), and at the same time, the highest in public coverage (49.4%).
Health insurance statistics by state further revealed that North Dakota had the highest rate of insured individuals through private coverage (79.7%). In comparison, Utah had the lowest insurance owner rate by public coverage (21.3%).
Employer-based Health Insurance Stats
11. Around 49% of the entire American population receive employer-paid health insurance.
(eHealth Insurance)
About 157 million Americans receive health insurance benefits from their employers. Employment-tied health coverage or group insurance is standard for larger businesses with more than 50 full-time employees.
That justifies why California has the most people covered by group insurance (more than 18 million) per state population, given that the vastest tech businesses have headquarters there.
Moreover, Texas (13.1 million), New York (9.5 million), Florida (8.1 million), and Illinois (6.7 million) constitute the top five states with the highest number of people covered by group insurance.
12. Employer-sponsored coverage slightly rose from 55.2% in 2018 to 55.4% in 2019.
(Census / Intuit)
Health insurance coverage statistics revealed no substantial change in employer-provided coverage between 2018 and 2019. Employer-based group health insurance is a proven viable option for workers to get coverage without burning a hole in their pockets.
The new healthcare law stresses that employer-sponsored health insurance should be affordable. That said, premiums paid by employees shouldn’t exceed 9.5%.
Uninsured Health Insurance Stats
13. The national average percentage for uninsured individuals in 2019 was 9.5%.
(Statista)
The uninsured rate was highest among the Hispanic population, which constituted over 27% in the first half of 2019. Asian Americans had the lowest uninsured rate, which was only at 7.4%.
14. In 2019, 26.1 million Americans didn’t have health insurance.
(Census)
Appalling US health insurance statistics 2019 reveals that out of over 320 million Americans, 8% or 26.1 million citizens were uninsured. That was about a million more than in 2018. A few rational reasons are that the number of uninsured Americans is rising, such as the difference in the Affordable Care Act and lost employment. Several workers have health insurance plans tied to their jobs. Therefore, losing their job would mean the end of healthcare coverage as well.
15. In 2018’s tax year, the penalty for uninsured adults was $695 plus inflation adjustment or 2.5% of yearly household income, whichever was higher.
(Healthcare.gov)
People who went without health insurance in 2018 were penalized upon filing their federal tax returns in April 2019. Published US health insurance statistics 2018 shared that each adult had paid $695 and each child $347.50, plus inflation adjustment for going without health coverage. The following year there was no longer individual shared responsibility payment or penalty because of the revocation of the individual mandate.
16. Uninsured American health care statistics in 2020 revealed that 43.4% of Americans ages 19 to 64 were inadequately insured.
(Commonwealth Fund)
A survey conducted of over 4000 adults showed that 43.4% or more than 2 of 5 Americans didn’t have sufficient coverage during the first half of 2020.
Despite the economic downturn caused by the global coronavirus outbreak, there wasn’t any substantial change in the rate of health insurance coverage since 2018. That may indicate the people’s growing incapability to pay for health coverage or perhaps of their declining interest in insurances.
17. Health insurance data unveiled higher uninsured rates for people of color; 40% for Latino and 24% for Black.
(Commonwealth Fund)
A comparative survey disclosed that more than 1 in 3 Latino adults aged 19 to 64 were uninsured. Next were Black Americans, which comprised an uninsured rate of 24%.
Specified facts about low incomes and small business employment attributed to higher uninsured rates of these ethnic groups.
Further uninsured American health care statistics in 2019 shared that among age groups, adults aged 19 to 34 had the highest uninsured percentage, making up 28% of the entire survey respondents.
Health Insurance Coverage Trends
18. Currently, 6 of 50 states have an individual health insurance mandate covering 2020 to 2021.
(HealthSherpa)
When the Affordable Care Act (ACA) or Obamacare came into effect in 2010, it was required for every US citizen to have health coverage, as stated in the “individual mandate.” People without health insurance were obliged to pay a fine then.
In December 2017, however, President Trump signed a law, which removed the individual mandate’s penalty fee across the country. As of January 1, 2019, the “individual mandate” was no longer valid.
Recent U.S. health insurance statistics 2020 confirmed that six states had kept their unique version of the individual mandate. Therefore, if you reside in any of these states: California, Washington D.C., New Jersey, Massachusetts, Rhode Island, and Vermont, you need to have health insurance.
Otherwise, you’ll have to pay a fine, except for people living in Vermont, as there’s no financial sanction attached to the mandate.
19. National healthcare expenditure is supposed to have an annual average growth of 5.4% from 2019 onward, reaching $6.2 trillion by 2028.
(CMS)
Several factors contribute to the rising healthcare expenses, such as the climbing costs for medical services, the growing aging population, the increasing number of chronic illnesses, and more.
In 2019, the NHE recorded only $3.8 trillion in healthcare spending. In nine years, it may nearly double because the current statistics on health insurance prove that inflation and costs can highly drive spending to $6.2 trillion.
20. This year, employees will pay moderately higher insurance premiums, about $3000.
(U.S. News)
Employers of big companies will continue to shoulder the sizable portion of premiums for employer-sponsored insurances. The company will settle as much as 81% of the rewards for employee-only coverage and 78% for family coverage.
Conclusion
Medicare, Medicaid, Obamacare—these are the extent of what ordinary people typically know about health insurance in the US. However, there’s more to these terms, and people, especially those interested in health insurance statistics, should find out more. There might be some benefits that they’re eligible for, but they don’t know.
America’s health insurance is a patchwork of programs, covering both private and public providers. As good as these programs can be, many Americans strongly feel that the existing system needs improvement. Some are starting to get enraged at paying expensive premiums.
Ever since health insurance coverage had become non-mandatory in 2019, the unstoppable escalating cost had slowly expanded people’s disinterest in it. We never know where this can lead to if the health insurance system remains unreformed.
People Also Ask
Yes, Obamacare is still active. Although the “individual mandate” clause is no longer functioning since December 2017. Previously, Americans were obliged by law to have qualifying health coverage; otherwise, they’d pay a fine. After President Trump signed the Tax Cuts and Jobs Act of 2017, it dissolved the individual mandate, and uninsured citizens didn’t need to pay the penalty.
According to statistics, 9 out of 10 Americans have health insurance. However, at the time of the pandemic, approximately 7.7 million Americans lost their jobs, which meant the end of employer-sponsored insurances to them.
Under the previous “individual mandate” clause of the Affordable Care Act (ACA), every American without health insurance would be penalized. However, this particular clause dropped, and by January 1, 2019, the mandate was no longer effective.
Today, health insurance is no longer mandatory, except in California, Washington D.C., New Jersey, Massachusetts, Rhode Island, and Vermont, which implemented their mandate.
Sources reveal that 92% of the US population has health insurance. Even if this is a reasonable rate, some insurance experts believe the figure should be higher. Trying to make health insurance more accessible, the government launched several programs, and one is the Affordable Care Act. Thanks to it, the US has had about 20 million fewer uninsured since its start.
According to Statista, the national average rate for Americans without insurance was 9.5% in 2019. It may seem like an insignificant number, but it represents millions of uninsured Americans. Health insurance cost has been a thorn to people’s flesh and is the most-cited reason why people can’t afford health insurance.
Private insurance companies typically offer budget-friendly and various types of plans to fit people with limited financial resources. In addition, the Affordable Care Act provides financial assistance to low- and middle-income Americans, so they get coverage.
According to health insurance statistics, if the household income falls between 100% and 400% of the poverty level, they may qualify to receive premium subsidies to cover the insurance payment. The application can be through the state’s government-run health insurance marketplace or qualifying licensed agents and private online marketplaces collaborating with the government marketplace.
