TENNESSEE S UNINSURED IN 2017

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DATA REPORT September 27, 2018 TENNESSEE S UNINSURED IN 2017 The U.S. Census Bureau released new data this month on health insurance coverage across the U.S. in 2017. Here are our top 3 takeaways for Tennessee. See the Metro Area Charts section at the end for Tennessee metro area data. KEY TAKEAWAYS In 2017, 629,142 Tennesseans were uninsured, about 37,000 more individuals than in 2016. The uninsured rate in Tennessee increased from 9.0% in 2016 to 9.5% in 2017. The largest increased in the uninsured rate occurred among 18-24 year olds, Tennesseans with incomes between $50,000 and $75,000, and individuals with less than a high school diploma. 1. Tennessee s uninsured rate increased in 2017. The proportion of Tennesseans who were uninsured increased from 9.0% in 2016 to 9.5% in 2017 (Figure 1). The number of uninsured Tennesseans increased by about 37,000 from 592,310 in 2016 to 629,142 in 2017 Nationally, the uninsured rate increased from 8.6% to 8.7%. FIGURE 1. THE UNINSURED RATE IN TENNESSEE, 2009-2017 Source: U.S. Census Bureau, 2016-2017 American Community Survey 1-year estimates (1) The Sycamore Institute SycamoreInstituteTN.org

2. Uninsured rates varied significantly by age and race/ethnicity. Working-age adults 19-64 had higher uninsured rates (14.0%) than children and older adults. (Figure 2) The uninsured rate increased for all age groups except 35-44 year olds. o The largest increase was among 18-24 year olds from 12.4% in 2016 to 15.0% in 2017. Uninsured rates were highest among Hispanic or Latino Tennesseans (29.8%) and lowest among American Indian/Alaska Natives (AI/AN) (7.1%). (Figure 3). While uninsured rates increased for most, decreases in the uninsured rate were seen among 2 racial/ethnic groups AI/AN and Hispanic or Latino. (Figure 3) FIGURE 2. THE UNINSURED IN TENNESSEE BY AGE Source: U.S. Census Bureau, 2016-2017 American Community Survey 1-year estimates (1) FIGURE 3. THE UNINSURED IN TENNESSEE BY RACE/ETHNICITY Hispanic or Latino includes individuals of any race. Source: U.S. Census Bureau, 2016-2017 American Community Survey 1-year estimates (1) 2 SycamoreInstituteTN.org

3. Uninsured rates were higher for Tennesseans with lower incomes and less education. Uninsured rates were higher for Tennesseans with lower incomes. 15.4% of Tennesseans living in households with incomes below $25,000 were uninsured compared to 4.6% living in households with incomes above $100,000 (Figure 4). o 17.0% of Tennesseans with incomes below 138% of the poverty threshold were uninsured compared. Uninsured rates were higher for Tennesseans with lower levels of education. 21.3% of Tennesseans with less than a high school education were uninsured compared to 4.4% with a bachelor s degree or higher (Figure 4). Uninsured rates increased across all income groups and most education levels. (Figure 4) o The uninsured rate increased the most for Tennesseans with incomes between $50,000 and $75,000 from 8.2% in 2016 to 9.2% in 2017 and for individuals with less than a high school diploma from 20.2% in 2016 to 21.3% in 2017. FIGURE 4. THE UNINSURED IN TENNESSEE BY INCOME & EDUCATION Source: U.S. Census Bureau, 2016-2017 American Community Survey 1-year estimates (1) You can read the Census Bureau s full report at Health Insurance Coverage in the United States: 2017 3 SycamoreInstituteTN.org

About Metro Areas METRO AREA CHARTS The U.S. Census Bureau s September data release also includes 2017 estimates for 5 metropolitan statistical areas (MSAs) that include Tennessee cities. MSAs include population centers and their surrounding areas including areas that can cross state lines (2) Later in the year, the Census will release county-level estimates using 5 years of data (2013-2017). Chattanooga, TN Metro Area Uninsured Rates The Chattanooga, TN metropolitan statistical area (MSA) includes Chattanooga and its surrounding areas including areas in Georgia. A map of Tennessee s MSAs can be viewed here. FIGURE 5. THE UNINSURED RATE, 2009-2017 Chattanooga, TN Metro Area FIGURE 6. THE UNINSURED IN 2017 Chattanooga, TN Metro Area FPL = federal poverty level. Hispanic or Latino includes individuals of any race. AI/AN = American Indian/Alaskan Native Source: U.S. Census Bureau, 2017 American Community Survey 1-year estimates (1) 4 SycamoreInstituteTN.org

Kingsport - Bristol, TN Metro Area Uninsured Rates The Kingsport-Bristol, TN metropolitan statistical area (MSA) includes Kingsport, TN, Bristol, TN, Bristol, VA and their surrounding areas including areas in Virginia. A map of Tennessee s MSAs can be viewed here. FIGURE 7. THE UNINSURED RATE, 2009-2017 Kingsport - Bristol, TN Metro Area FIGURE 8. THE UNINSURED IN 2017 Kingsport - Bristol, TN Metro Area FPL = federal poverty level. Hispanic or Latino includes individuals of any race. AI/AN = American Indian/Alaskan Native Source: U.S. Census Bureau, 2017 American Community Survey 1-year estimates (1) 5 SycamoreInstituteTN.org

Knoxville, TN Metro Area Uninsured Rates The Knoxville, TN metropolitan statistical area (MSA) includes Knoxville and its surrounding areas. A map of Tennessee s MSAs can be viewed here. FIGURE 9. THE UNINSURED RATE, 2009-2017 Knoxville, TN Metro Area FIGURE 10. THE UNINSURED IN 2017 Knoxville, TN Metro Area FPL = federal poverty level. Hispanic or Latino includes individuals of any race. AI/AN = American Indian/Alaskan Native Source: U.S. Census Bureau, 2017 American Community Survey 1-year estimates (1) 6 SycamoreInstituteTN.org

Memphis, TN Metro Area Uninsured Rates The Memphis, TN metropolitan statistical area (MSA) includes Memphis and its surrounding areas including areas in both Mississippi and Arkansas. A map of Tennessee s MSAs can be viewed here. FIGURE 11. THE UNINSURED RATE, 2009-2017 Memphis, TN Metro Area FIGURE 12. THE UNINSURED IN 2017 Memphis, TN Metro Area FPL = federal poverty level. Hispanic or Latino includes individuals of any race. AI/AN = American Indian/Alaskan Native Source: U.S. Census Bureau, 2017 American Community Survey 1-year estimates (1) 7 SycamoreInstituteTN.org

Nashville Murfreesboro - Franklin, TN Metro Area Uninsured Rates The Nashville-Murfreesboro-Franklin, TN metropolitan statistical area (MSA) includes Nashville, TN, Murfreesboro, TN, and Franklin, TN and their surrounding areas. A map of Tennessee s MSAs can be viewed here. FIGURE 13. THE UNINSURED RATE, 2009-2017 Nashville-Murfreesboro-Franklin, TN Metro Area FIGURE 14. THE UNINSURED IN 2017 Nashville-Murfreesboro-Franklin, TN Metro Area FPL = federal poverty level. Hispanic or Latino includes individuals of any race. AI/AN = American Indian/Alaskan Native Source: U.S. Census Bureau, 2017 American Community Survey 1-year estimates (1) 8 SycamoreInstituteTN.org

DATA TABLE: THE UNINSURED IN TENNESSEE IN 2017 Tennessee Chattanooga, TN Metro Area Kingsport-Bristol, TN Metro Area Knoxville, TN Metro Area Memphis, TN Metro Area Nashville- Murfreesboro- Franklin, TN Metro Area Total Uninsured, 2017 629,142 9.5% 53,209 9.7% 23,127 7.7% 73,028 8.4% 130,372 9.8% 179,489 9.5% 2016 592,310 9.0% 46,511 8.5% 26,549 8.7% 69,581 8.1% 133,995 10.1% 161,705 8.7% 2015 667,417 10.3% 49,408 9.2% 25,807 8.5% 80,428 9.4% 158,624 12.0% 176,480 9.7% 2014 776,319 12.0% 64,632 12.0% 36,648 11.4% 92,244 10.9% 177,363 13.4% 212,056 11.9% 2013 886,662 13.9% 72,868 13.6% 39,422 12.9% 96,902 11.5% 208,709 15.7% 234,084 13.5% 2012 882,120 13.9% 76,734 14.4% 40,040 13.1% 81,866 11.6% 199,113 15.1% 213,210 13.1% 2011 922,650 14.6% 72,037 13.8% 39,851 12.9% 86,650 12.4% 211,256 16.2% 229,705 14.3% 2010 898,561 14.4% 79,157 15.1% 38,726 12.6% 82,114 11.9% 207,802 16.0% 227,085 14.4% 2009 883,315 14.3% 72,649 14.0% 40,362 13.5% 75,643 10.9% 210,194 16.3% 208,662 13.3% By Age, 2017 Under 19 70,779 4.4% 7,903 6.4% 1,779 2.8% 5,333 2.7% 14,491 4.1% 26,088 5.5% 19-64 554,489 14.0% 44,924 13.6% 21,228 12.2% 67,229 12.9% 115,301 14.5% 152,213 12.9% 65+ 3,874 0.7% 382 0.4% 120 0.2% 466 0.3% 580 0.3% 1,188 0.5% By Race/Ethnicity, 2017 White 456,492 8.9% 42,629 9.5% 21,484 7.5% 62,870 8.1% 42,454 6.9% 137,492 9.3% Black 112,886 10.3% 6,577 9.0% 662 11.3% 4,353 9.0% 67,479 11.0% 24,650 8.9% Asian 12,572 10.6% 1,407 13.8% n/a n/a 2,195 14.7% 2,044 7.4% 5,519 10.6% Hispanic 106,473 29.8% 6,171 24.7% 633 12.3% 7,693 23.2% 25,095 33.9% 43,016 31.5% AI/AN 1,025 7.1% n/a n/a n/a n/a n/a n/a n/a n/a 404 8.3% By Household Income, 2017 <138% of Poverty, 2017 251,976 17.0% 21,926 19.9% 10,222 13.9% 29,554 15.4% 60,220 18.5% 57,847 18.6% Under $25K 177,124 15.4% 15,907 17.5% 7,631 12.7% 22,620 15.5% 42,365 17.1% 34,443 15.8% $25,000 to $49,999 182,009 12.1% 14,428 12.0% 8,488 9.9% 19,950 10.0% 40,453 13.3% 47,286 14.0% $50,000 to $74,999 120,806 9.2% 10,950 10.6% 2,499 4.0% 13,937 8.9% 22,050 9.0% 38,888 10.1% $75,000 to $99,999 64,566 7.1% 3,727 4.8% 2,199 6.3% 8,615 6.5% 12,372 7.4% 26,467 9.0% $100,000 and over 76,754 4.6% 6,780 4.6% 2,106 3.7% 7,233 3.2% 11,816 3.3% 30,655 4.9% 9 SycamoreInstituteTN.org

THE SYCAMORE INSTITUTE The Sycamore Institute is an independent, nonpartisan public policy research center for Tennessee. Sign up for email alerts at: SycamoreInstituteTN.org Written By Courtnee Melton, PhD Policy Analyst CMelton@SycamoreInstituteTN.org Other TSI Staff Laura Berlind Executive Director Mandy Pellegrin Policy Director Brian Straessle Communications Director Related Work by The Sycamore Institute Health Insurance Coverage in Tennessee in 2016 (October 5, 2017) Analyzes 2016 data on the rate of the uninsured and where insured Tennessean s get health coverage. How Uninsured Rates in Tennessee Counties Vary by Employment and Income (January 30, 2018) Provides 2016 county-level data on uninsured rates by employment and income. Click here for all Affordable Care Act (ACA)-related posts by The Sycamore Institute. References 1. U.S. Census Bureau. American Community Survey 1-year estimates. Table S2701. [Online] 2009-2017. [Accessed on September 13, 2018.] Accessed via factfinder.census.gov. 2.. Geographic Terms and Concepts - Core Based Statistical Areas and Related Statistical Areas. [Online] https://www.census.gov/geo/reference/gtc/gtc_cbsa.html#mesa. 10 SycamoreInstituteTN.org