Fewer Americans have health insurance

The percentage of Americans with health insurance fell last year for the first time since the 2009, according to data from the U.S. Census Bureau.

27.5 million Americans, 8.5% of the population, were without health cover in 2018 compared to 25.6 million Americans, or 7.9% of the population, in 2017.

Government programmes like Medicaid and Medicare are regarded as public cover. Plans purchased through the federal marketplace established by the 2010 Affordable Care Act count as private cover.

Private health insurance remains the more prevalent form of health insurance as private firms cover 67.3%, while 34.4% have public healthcare. Cover through an employer is the most common type of insurance, with 55.1% receiving care through their job.

Medicaid provides public health insurance for people with low incomes who aren’t elderly. Medicare provides public health insurance for people aged 65 and older, and for some younger people with disability.

On the public health schemes, the number of people covered by Medicaid fell but the number covered by Medicare increased. This increase was driven by growth in the number of people age 65 and over. Among those 65 years and older, the Medicare coverage rate did not statistically change between 2017 and 2018, despite the proportion of U.S. population 65 years and older increasing.

17.9% of Americans had Medicaid in 2018, a 0.7% drop in coverage, but Medicare coverage increased to 17.8%, a 0.4% increase. More children, ages 19 and under, lacked health-care coverage in 2018 compared to a year earlier.

The data comes as the Trump administration and some other Republican lawmakers have made efforts to repeal the Affordable Care Act. The law passed in 2012 mandated that all Americans enrol in some form of health insurance or face a fine.

There is a medical tourism myth that these uninsured Americans are targets for overseas healthcare. They are mostly too poor to afford this, a substantial number of them have no passport and, as not qualifying for free healthcare, are likely to be healthy.

But for people with a high deductible, seeking treatment for cover not insured such as dental care and cosmetic surgery, there may still be a specific market to target.