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1 1 (November 2, 2017)

handle is hein.crs/govcexu0001 and id is 1 raw text is: 01;0cc)nSWfasrES $rh& mppm qq\ a , q goo I 'S 11LULANJILiN, Updated November 2, 2017 Coverage in the Private Health Insurance Market Americans obtain health insurance through a variety of methods and from different sources. People may get insurance through the private sector or from a government source, or individuals may go uninsured. ,-vate ea k sr Mark, The private health insurance market includes both the group market (largely made up of employer-sponsored insurance, or ESI) and the non-group market (commonly referred to as the individual market, see Figure 1). Private health insurance does not include government sources of coverage, such as Medicare or Medicaid. Figure I. Private Health Insurance Sources of Coverage G- ro up Smas - gcSHO mk market --es group exhanges Z m a rke t ........................... ..... Source: Congressional Research Service (CRS). Notes: SHOP = Small Business Health Options Program. A SHOP exchange is where small businesses can purchase small-group insurance and apply for small business health insurance tax credits. The dynamic nature of health insurance coverage results in nuanced estimates of coverage, which often depend on the time frame being measured. For example, at the time of the measurement, an individual may indicate having Medicare coverage only. However, when measuring coverage in the past year, that same individual may indicate having had private insurance coverage for part of the year and Medicare for part of the year. People also may have multiple sources of coverage simultaneously within a time frame (e.g., Medicare and supplemental private health insurance at the time of interview); thus, estimates by type of coverage are not always mutually exclusive. This In Focus primarily uses estimates from the Census Bureau's Current Population Survey Annual Social and Economic Supplement (CPS ASEC) to provide estimates of coverage in the private health insurance market for 2013- 2016. The CPS ASEC measures any coverage and type of health insurance coverage for all or part of the year. Private health insurance is the predominant source of health insurance coverage in the United States. In 2016, 67.5% of the U.S. population (216.2 million people) had private coverage through either the group or the non-group market during all or part of the year (see Figure 2). Figure 2. Private Health Insurance Coverage in the United States, 2013-2016 80% 64.1% 66.0% 67.2% 67.5% '--- --¢. , . 60% ,,x', ............... ..................... , I d, :: •• .-.-.-.-. ,- . , -.-.-.-.-. ,,,, -....... .......... .. ... 55.7% 55.4% 5S,7% S5.7% ...... 20% 114% 14.6% 16.3% 16.2% .................. ... 0% 2013 2014 2015 2016 Source: U.S. Census Bureau, Current Population Survey, 2014, 2015, 2016 and 2017 Annual Social and Economic Supplements. Notes: Coverage is measured during all or part of the year. The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year. Grotp llsrance Group health insurance is typically offered by employers and is divided into small-group and large-group segments. The distinction between the small-group and large-group markets is defined by the size of the employer or other organization purchasing a group plan. Most states define small group as businesses having 50 or fewer employees and large group as businesses having more than 50 employees. A majority of Americans obtain health coverage through the group market. In 2016, 55.7% of the U.S. population (178.5 million people) had group coverage during all or part of the year (see Figure 2). The CPS ASEC does not further differentiate between small-group and large-group coverage. Consumers who are not associated with a group can obtain health coverage by purchasing it directly from an insurer in the non-group insurance market. In general, the non-group market enrolls many people who do not receive coverage from an employer and who are otherwise ineligible for public insurance programs, such as Medicare or Medicaid.

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