May 2016 Laura Skopec Jason Gates Michael Karpman and Genevieve M Kenney The Urban Institute Methods All data are from the American Community Survey ACS the Behavioral Risk Factor Surveillance System BRFSS and the Current Population Survey CPS ID: 622823
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Slide1
The Uninsured in Virginia: An Update for the Virginia Health Care Foundation
May 2016
Laura
Skopec, Jason Gates,
Michael Karpman, and
Genevieve M. Kenney
The Urban InstituteSlide2
Methods
All data are from the American Community Survey (ACS), the Behavioral Risk Factor Surveillance System (BRFSS), and the Current Population Survey (CPS)
The
family structures and corresponding income and employment estimates presented in the ACS analyses are based on tax units, or groups of individuals whose income would likely be counted together for the purposes of eligibility for Medicaid or the Marketplace. Tax units are generally smaller than Census-reported families, and their income is generally lower than the Census estimates of family-based income. Therefore, the ACS estimates of the number of uninsured by income may not match those from other sources that are based on alternative family and income units. ACS estimates reflect additional Urban Institute adjustments for potential misreporting of Medicaid/CHIP coverage developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide3
Main Takeaways
The uninsured rate for the nonelderly in VA fell
1.8
percentage points between 2013 and 2014, from 14.3 percent to 12.5 percentThere were about 878,000 nonelderly uninsured in VA in 2014 73.3 percent of uninsured Virginians (643,000) live in families with income at or below 200 percent of the Federal Poverty Level (FPL)64.9 percent of uninsured children in Virginia (75,000) live in families with income at or below 200 percent of the Federal Poverty Level (FPL)Most uninsured Virginians are adults; a plurality are white and a majority are in working families
for the Virginia Health Care FoundationSlide4
Main Takeaways (continued)
Uninsured rates are higher in five regions of the state, two in the north and three in the south
Uninsured adults in VA are much more likely than insured
Virginians to have unmet needs and less likely to receive preventive services, even when controlling for observed differences between the two groupsEstimates in early 2015 from the CPS show that the uninsured rate in Virginia fell by 2.8 percentage points from March 2014 to March 2015, to 11.0 percent*, and that it remained below the uninsured rate for the nonelderly in the US as a whole.
for the Virginia Health Care Foundation
*Due to differences in survey questions, survey methods, survey timing, sample size, and sample characteristics, estimates from the 2014 CPS do not match estimates from the 2014 ACS. Slide5
Almost 880,000 Virginians
lack health insurance
coverage, 87.5 percent of whom are adults
Total Nonelderly
874,000
uninsured nonelderly
Source: Urban Institute,
March 2016
.
Based on the
2014
American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Nonelderly Uninsured
759,000
uninsured
nonelderly adults
for the Virginia Health Care FoundationSlide6
Adults
are
2.6
times more likely to be uninsured than children in Virginia
Source: Urban Institute,
March
2016
.
Based on the
2014
American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide7
Source: Urban Institute,
March 2016
.
Based on the
2014
American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation
. For area definitions, see “Guide to Regions of Virginia”.
Uninsured rate for all nonelderly (0-64) in Virginia in 2014, by region
for the Virginia Health Care FoundationSlide8
Source: Urban Institute,
March 2016
.
Based on the
2014
American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see “Guide to Regions of Virginia
”.
Uninsured rate for nonelderly adults (19-64) in Virginia in 2014, by region
for the Virginia Health Care FoundationSlide9
Source: Urban Institute,
March 2016
.
Based on the
2014
American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see “Guide to Regions of Virginia
”.
Uninsured rate for children (0-18) in Virginia in 2014, by region
for the Virginia Health Care FoundationSlide10
Uninsured rate for all nonelderly
(
0-64) with family incomes below 200 percent of the FPL in Virginia in 2014, by region
Source: Urban Institute,
March 2016
.
Based on the
2014
American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see “Guide to Regions of Virginia
”.
for the Virginia Health Care FoundationSlide11
Source: Urban Institute,
March 2016
.
Based on the
2014
American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see “Guide to Regions of Virginia
”.
Uninsured rate for children (0-18) with family incomes below 200 percent of the FPL in Virginia in 2014, by region
for the Virginia Health Care FoundationSlide12
Uninsurance among the nonelderly was lower in
VA
than the
United States as a whole during 2009-2014, but the gap narrowed
Note:
* indicates
the
2014
uninsured rate is statistically different from
2013
at the .10 level. # indicates the 2009 uninsured rate is statistically different from 2014
at the .10
level
.
Source: Urban Institute,
March 2016. Based
on the 2009, 2010, 2011, 2012, 2013, and 2014 American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide13
Uninsurance in Virginia decreased among adults, but held steady among children between 2013 and 2014
Note: * indicates the 2014 uninsured rate is statistically different from 2013 at the .10 level. # indicates the 2009 uninsured rate is statistically different from 2014 at the .10 level.
Source: Urban Institute,
March
2016. Based on the 2009, 2010, 2011, 2012, 2013, and 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS).
The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Nonelderly adults
Total Nonelderly
Children
for the Virginia Health Care FoundationSlide14
Over
forty percent of all uninsured Virginians live below the
federal poverty
level
Notes: Family poverty level estimates are based
on tax unit Modified Adjusted Gross Income and use the 2014 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human Services.
Source: Urban Institute,
March
2016
. Based on the 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide15
Just over 70 percent of Virginians
who are uninsured live in families with income at or below 200 percent of the FPL
Notes: Family poverty level estimates are based on tax unit Modified Adjusted Gross Income and use the 2014 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human Services.
Source: Urban Institute,
March
2016
. Based on the 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide16
Virginians
living below poverty are
nearly 10
times more likely to be uninsured compared to Virginians living at or above 401 percent of FPL
Notes: Family poverty level estimates are based on tax unit Modified Adjusted Gross Income and use the 2014 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human Services.
Source: Urban Institute,
March
2016
. Based on the 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide17
Over
70 percent of uninsured Virginians live in families with at least one full or part-time worker
Share of Nonelderly Uninsured
Notes: Family work status is based on the work status of
adults in the tax unit.
Estimates may not sum to 100% due to rounding.
Source: Urban Institute,
March
2016
. Based on the 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide18
Full-time
workers and their families make up
58.5
percent of the uninsured in Virginia and are distributed over all income levels
Notes: Family work status is based on the work status of adults in the tax unit.
Family poverty level estimates are based on tax unit Modified Adjusted Gross Income and use the 2014 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human
Services.
Estimates
may not sum to 100% due to rounding.
Source: Urban Institute,
March
2016
. Based on the 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide19
Just over 40 percent of
the
nonelderly uninsured
in Virginia
are white
, non-Hispanic
Notes: Estimates may not sum to 100% due to rounding.
Source: Urban Institute,
March
2016
. Based on the 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide20
Nearly
four-fifths of the
nonelderly uninsured
in Virginia are U.S.
Citizens
Notes: Estimates may not sum to 100% due to rounding.
Source: Urban Institute,
March
2016
. Based on the 2014 American Community Survey (ACS) data from the Integrated Public Use
Microdata
Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide21
Uninsurance
declined for young adults (19-26) in Virginia between
2013
and 2014
Note: * indicates the 2014 uninsured rate is statistically different from 2013 at the .10
level.
Source
: Urban Institute,
March 2016.
Based on the
2009, 2010, 2011, 2012, 2013 and 2014 American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS). The estimates reflect Urban Institute adjustments for potential misreporting of coverage, based on a simulation model developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
for the Virginia Health Care FoundationSlide22
Uninsurance among all nonelderly (0-64) in Virginia and the US continued to decline
between early 2014
and 2015 (CPS)
Note: Estimates shown are percentage point decreases.
The change in the uninsured rate between 2014 and 2015 was not statistically different between Virginia and the United States. Source
: Urban Institute,
March 2016.
Based on the
2014 and 2015 Current Population Survey.
for the Virginia Health Care FoundationSlide23
Note: Adults are age
18-64
. Measures refer to access or utilization over the past 12 months.
*/** Estimate is significantly different from estimate for Virginia at the 0.05/0.01 percent level
Source
: Urban
Institute, March 2016.
Based on the
2014 Behavioral
Risk Factor Surveillance System
.
for the Virginia Health Care FoundationSlide24
Note: Adults are age
18-64
. Measures refer to access or utilization over the past 12 months.
*/**
Estimate is significantly different from estimate for Virginia at the
0.05/0.01
percent level
Source
: Urban Institute,
March 2016.
Based on the 2014 Behavioral Risk Factor Surveillance System.
for the Virginia Health Care Foundation