A Profile of Virginia s Uninsured March 2018 Laura Skopec, Joshua Aarons, and Genevieve M. Kenney The Urban Institute
Methods All data are from the American Community Survey (ACS) and the Behavioral Risk Factor Surveillance System (BRFSS), which are conducted by the US Census Bureau and the Centers for Disease Control and Prevention, respectively. The family structures and corresponding income and employment estimates presented in the ACS analyses were 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. As a result, 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 on the ACS developed by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. This report provides more in-depth information than the tables produced by the US Census Bureau.
Main Takeaways There were about 718,000 nonelderly uninsured (ages 0-64) in Virginia in 2016. The uninsured rate for the nonelderly in Virginia fell 0.4 percentage points between 2015 and 2016, from 10.7% to 10.3%. In 2016, the uninsured rate in Virginia (10.3%) was statistically higher than the national average uninsured rate (9.9%) for the first time since insurance coverage questions were added to the ACS in 2008. The uninsured rate for children (ages 0-18) in Virginia was 4.9% in 2016. Approximately 97,000 children were uninsured.
Main Takeaways (continued) 70.3% of uninsured nonelderly Virginians (504,000) live in families with income at or below 200% of the Federal Poverty Level (FPL). 60.8% of uninsured children in Virginia (59,000) live in families with income at or below 200% of the FPL. Most uninsured Virginians are adults; 44.8% are white and 79.5% are in working families. Uninsured rates are higher in four regions of the state, one in the Prince William County area, one in the upper Piedmont area, one in Southside Virginia, and one in southwest Virginia. Uninsured adult Virginians are much more likely than insured adult Virginians to have unmet needs and less likely to receive preventive services.
718,000 Virginians lack health insurance coverage, 86.5% of whom are adults Total Nonelderly Virginians Nonelderly Uninsured Virginias Uninsured, 10.3% Children, 13.5% Insured, 89.7% Adults, 86.5% 718,000 uninsured nonelderly 621,000 uninsured nonelderly adults by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Adults are 2.5 times more likely to be uninsured than children in Virginia 20% 15% Uninsurance Rate 10% 5% 4.9% 12.4% 10.3% 0% Children Adults All Nonelderly by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Uninsured rate for all nonelderly Virginians (0-64) in 2016, by Region 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 adult Virginians (19-64) in 2016, by Region by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see Guide to Regions of Virginia.
Uninsured rate for Virginia children (0-18) in 2016, by Region 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 Virginians (0-64) with family income below 200% of the FPL in 2016, by Region by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see Guide to Regions of Virginia.
Uninsured rate for Virginia children (0-18) with family income below 200% of the FPL in 2016, by Region by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see Guide to Regions of Virginia.
Uninsured rate for adult Virginians (19-64) with family income below 100% of the FPL in 2016, by Region by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see Guide to Regions of Virginia.
Uninsured rate for adult Virginians (19-64) with family income below 138% of the FPL in 2016, by Region by Victoria Lynch under a grant from the Robert Wood Johnson Foundation. For area definitions, see Guide to Regions of Virginia.
Uninsured Virginians Income Eligible for Expanded Medicaid Note: The estimated share of uninsured adults with incomes at or below 138% of the FPL does not reflect other Medicaid eligibility requirements like immigration status. 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 first time since 2009, uninsurance among the nonelderly (0-64) was lower in the United States than in Virginia 25% 20% 15% 10% 17.5% 17.9% 17.5% 17.1% 16.9% 13.5% 14.6% 14.2% 14.3% 14.3% 13.4% 12.5% 10.8% 10.7% 10.3%*# 9.9%*# 5% Virginia United States 0% 2009 2010 2011 2012 2013 2014 2015 2016 Note: * indicates the 2016 uninsured rate is statistically different from 2015 at the.10 level. # indicates that 2016 uninsured rate is statistically different from 2009 at the.10 level. Source: Urban Institute, March 2018. Based on the 2009, 2010, 2011, 2012, 2013, 2014, 2015 and 2016 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.
Uninsurance in Virginia decreased among both nonelderly adults and children between 2009 and 2016 25.0% 20.0% 15.0% 10.0% 16.4% 13.5% 17.9% 17.6% 17.8% 17.8% 14.6% 14.2% 14.3% 14.3% 15.1% 12.5% 13.1% 12.4%*# 10.7% 10.3%*# 5.0% 0.0% 6.7% 6.4% 5.7% 5.5% 5.5% 5.8% 4.7% 4.9%# 2009 2010 2011 2012 2013 2014 2015 2016 Total Nonelderly Children Adults Note: * indicates the 2016 uninsured rate is statistically different from 2015 at the.10 level. # indicates that 2016 uninsured rate is statistically different from 2009 at the.10 level. Source: Urban Institute, March 2018. Based on the 2009, 2010, 2011, 2012, 2013, 2014, 2015 and 2016 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.
More than 40% of nonelderly uninsured Virginians live below the FPL 100% 75% 50% 25% 8.1% 11.9% 7.3% 8.5% 14.3% 18.8% 15.3% 12.0% 20.4% 11.2% 43.0% 29.2% 7.5% 7.1% 13.7% 14.5% 12.1% 45.1% 401+% FPL 301-400% FPL 201-300%+% FPL 139-200% FPL 100-138% FPL <100% FPL 0% Total Nonelderly Children Adults Notes: Family poverty level estimates are based on tax unit Modified Adjusted Gross Income and use the 2016 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human Services. by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
70% of nonelderly Virginians who are uninsured live in families with income at or below 200% of the FPL 100% 75% 70.3% 71.7% 60.8% 50% 25% 0% Total Nonelderly Children Adults Notes: Family poverty level estimates are based on tax unit Modified Adjusted Gross Income and use the 2016 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human Services. by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Virginians living below the FPL are more than 8 times as likely to be uninsured as Virginians living at or above 401% of the FPL 25% 20% 18.5% 20.7% 18.1% 15% 11.7% 10% 7.0% 5% 0% <100% FPL 100-138% FPL 139-200% FPL 201-300%+% FPL 2.2% 301-400% FPL 401+% FPL Notes: Family poverty level estimates are based on tax unit Modified Adjusted Gross Income and use the 2016 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human Services. by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Nearly four out of five (79.5%) uninsured Virginians live in families with at least one full or part-time worker Share of Nonelderly Uninsured No working adults, 19.7% Part-time worker(s) only, 16.4% Child Not Living with Parents, 0.7% Two full time workers, 11.7% One full-time worker, 51.4% 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. by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Full-time workers and their families comprise 63.1% of the uninsured in Virginia and are distributed over all income levels 100% 11.5% % of total uninsured 75% 50% 25% 0% 11.0% 19.0% 20.3% 13.1% 25.1% Full-Time Workers and Their Families 401+% FPL 301-400% FPL 201-300% FPL 139-200% FPL 100-138% FPL <100% FPL 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 2016 Federal Poverty Levels (FPLs) defined by the US Department of Health and Human Services. Estimates may not sum to 100% due to rounding. by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Nearly 45% of uninsured nonelderly Virginians are white, non-hispanic Black or African American, 19.6% Asian/Pacific Islander, 5.7% White, 44.8% Other/Multiple, 3.8% Hispanic, 26.0% Notes: Estimates may not sum to 100% due to rounding. by Victoria Lynch under a grant from the Robert Wood Johnson Foundation.
Uninsurance for young adult Virginians (19-26) continued to decline in 2016 30.0% 25.0% 26.3% 27.6% 24.6% 22.3% 22.2% 20.0% 15.0% 19.4% 16.8% 14.7%*# 10.0% 5.0% 0.0% 2009 2010 2011 2012 2013 2014 2015 2016 Note: * indicates the 2016 uninsured rate is statistically different from 2015 at the.10 level. # indicates that 2016 uninsured rate is statistically different from 2009 at the.10 level. Source: Urban Institute, March 2018. Based on the 2009, 2010, 2011, 2012, 2013, 2014, 2015 and 2016 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.
Uninsured adults in Virginia are more likely than insured adults to have health problems and are less likely to receive care 100% 80% 80.3 74.6 75.0 Insured Uninsured 60% 40% 35.9** 45.5** 40.6 42.6 ** 49.8** 33.6 47.8 ** 20% 0% Regular Provider Routine Checkup 20.1** 10.0 Flu Shot Dental Visit Unmet Needs Due to Cost 7.2 22.5** Unmet Medication Needs Due to Cost 16.4 18.5** Depressive Disorder 3.4 5.4 ** Not Good Mental Health (Days) Note: Adults are age 18-64. Measures refer to access or utilization over the past 12 months except lost any teeth, which is over the respondent s lifetime. ** Estimate is significantly different from estimate for Virginia at the 0.01 percent level Source: Urban Institute, March 2018. Based on the 2016 Behavioral Risk Factor Surveillance System. Lost Any Teeth