What the Census Can Tell Us About Health Insurance

The U.S. Census, done every ten years to build current a base of knowledge about the “people, places and economy” of America, is one of the most important tools used by American policy makers. But sometimes the census fuels controversy. In 2010, one of the most hotly debated subjects in public policy was that of health insurance and coverage. A recent decision by the United States Supreme Court upheld a groundbreaking health care reform bill, the The Patient Protection and Affordable Care Act (PPACA) has sparked massive controversy over the future of health insurance in this country. There are concerns and philosophical differences on both sides of the debate, and much of the time, it can be hard to know what information being aired is legitimate, and which information is biased and untrue. One of, if not the best, source for the accurate facts regarding the American people and health insurance is the data found in the 2010 census itself.

Summary Findings

As summed up by the 2010 report published by the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), the information collected by surveyors in all 50 states, as well as the District of Columbia, the basic and most important finding are the following:

  • Real median household income declined between 2009 and 2010.
  • The poverty rate increased between 2009 and 2010.
  • The number of people without health insurance increased between 2009 and 2010, from 49.0 million to 49.9 million, while the 2010 uninsured rate (16.3) was not statistically different from the 2009 uninsured rate.

It is important to note all these findings in order to understand the final one regarding health insurance. The basic facts are that under the old system which has now been altered by the recent legislation (with most of the changes due to occur in 2014), more people lost their health insurance over the course of a year, even though the rates did not dramatically go up. Let us now take a look at some of the specific facts found within the report.


According to the report itself, underreporting of health insurance is a problem within the survey. Apparently, “while underreporting affects most, if not all, surveys, underreporting of health insurance coverage appears to be a larger problem in the Annual Social and Economic Supplement (ASEC) than in other national surveys that ask about insurance.” There are a few reasons that this is the case: higher focus on other areas, such as household income; as well as the disparity of time between the period of insurance coverage which is asked about (the previous year) as compared to the current status of the interviewees coverage. The CPS apparently estimates that the number of people who are without health insurance is more accurately approximated by those without insurance during a specific period of time during the year than those who are uninsured throughout the entirety of the year. The comparison of federal surveys which looked at health insurance rates was published by the Congressional Budget Office (CBO) in their report, How Many People Lack Insurance and for How Long?

Coverage Statistics

Although the amount of people without health insurance in 2010 increased to 256.2 million (as compared to 255.3 million in 2009), most of the other rates of coverage remained the same. The number, percentage-wise, of people who did have health insurance was not statistically different. Nor was the percentage of people covered by Medicaid (15.9 percent), or the number of children who were uncovered (9.8 percent; or 7.3 million), much different in 2009 as compared to 2010.

The rate of uninsured children in poverty did increase from the previous year, while households that saw income grow also saw an increase in health insurance coverage.

Racial and Nativity Statistics

The Census Bureau Newsroom reported that, “the uninsured rate and number of uninsured in 2010 were not statistically different from 2009 for non-Hispanic whites and blacks, while increasing for Asians.” There was no statistical difference in the number of uninsured Hispanics  from 2009, while “the uninsured rate decreased to 30.7 percent.”

The proportion of citizens born elsewhere who were uninsured was 2-and-a-half times larger than that of people born in the country. Meanwhile, the percentage of native-born citizens who were uninsured did not grow from 2009 to 2010, nor did it for foreign born or non-citizens, but it did for the naturalized citizens.

Looking Ahead

Future census data will help us compare the rates of those with and without insurance pre-and-post the Affordable Care Act. Certain specifics within the act will fundamentally alter
the statistics; such as with the rate of uninsured children. Now that insurance companies are no longer able to deny coverage to people with pre-existing conditions, more people who previously could afford coverage but were denied it, are likely to be covered. Moreover, the fine (or tax) levied against those who do not get coverage is likely to have an effect on the number of citizens covered, and may even affect the income and poverty rates. It is impossible to tell what specific changes we will find, but the insurance system, and likely the economy, is going to be very different come the next census, so it will interesting to note the changes made in regards to their effectiveness, compared with the previous system and findings.