Idaho’s uninsured population drops 2%

Newly released census data indicates Idaho had the second-largest reduction in its uninsured population in the nation over the past three years.

The American Community Survey data comes at a time when the Idaho Legislature is preparing to review and possibly modify Medicaid expansion, which is the program that’s largely responsible for the decrease in the state’s uninsured population.

Voters approved the Medicaid expansion initiative in 2018, after several years of inaction by the Idaho Legislature. The program provides health care services for people earning between 100% and 138% of the federal poverty level.

Coverage began in 2020. More than 130,000 Idahoans now receive health care through the program.

The American Community Survey is a demographics survey conducted by the U.S. Census Bureau. It’s sent to about 3.5 million people each year. It collects information on everything from ancestry and citizenship to educational level, income, disability status, employment and housing characteristics.

The latest survey results regarding health care coverage were released Thursday.

The data shows that the number of Idahoans who lack health care insurance decreased from 10.8% of the population to 8.8% from 2019 to 2021. That 2% declined compares with an average 0.5% reduction nationwide, and trails only Maine’s 2.3% reduction for the largest drop in the country during that time period.

Like Idaho, Maine expanded its Medicaid program after voters forced the issue through a ballot initiative. Coverage there began in 2019.

Republican lawmakers in both states have expressed concerns about the growing cost of Medicaid and, more generally, about increasing reliance on federal safety net programs.

After the 2018 ballot initiative passed, the Idaho Legislature reluctantly enacted Medicaid expansion. However, it included language in the bill directing the House and Senate health and welfare committees to “review all fiscal, health and other impacts of Medicaid eligibility expansion … (and) make a recommendation to the Legislature as to whether such expansion should remain in effect.”

The deadline for completing that review is Jan. 31.

The American Community Survey data indicates that the average uninsured rate in states that expanded Medicaid was 6.6% in 2021. That was nearly half the 12.7% average in the 14 non-expansion states.

Washington, which was one of the 24 states that expanded Medicaid in 2014, after Congress approved the Affordable Care Act, saw its uninsured rate decline from 6.6% to 6.4% from 2019 to 2021.

Nationally, more than two-thirds of Americans are covered by private health insurance, primarily through their employer.

However, that figure dropped slightly over the past three years, from 67.4% in 2019 to 67% in 2021, according to the survey data.

Reliance on public health care programs like Medicaid increased by 1.4% during that same time span. In Idaho, for example, the number of people covered by public health programs increased by 4.3%, from 32.5% to 36.8%. That was the largest percentage jump in the country.

Public health coverage in Washington increased from 35.2% to 36.5% during that same time period, according to the survey results.

Nationally, 8.6% of Americans lacked health insurance coverage in 2021. That was nearly half the 16.8% uninsured rate in 2013, before the Affordable Care Act passed.

Spence may be contacted at bspence@lmtribune.com or (208) 791-9168.