Education matters: despite improvements under the ACA, disparities in coverage based on educational level persist
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Health policy fact sheet (Online)
- Author(s):
- Kominski, Gerald F., author Rasmussen, Petra W., author Zhang, Chengcheng, author Hassan, Safia, author Freund, Deborah, author
- Contributor(s):
- UCLA Center for Health Policy Research, issuing body.
- Publication:
- Los Angeles, CA : UCLA Center for Health Policy Research, January 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Educational Status Insurance Coverage California United States United States.
- Genre(s):
- Technical Report
- Abstract:
- Since 2013, the Affordable Care Act (ACA) has produced significant reductions in the number of uninsured individuals. Nevertheless, important disparities persist among the remaining uninsured. Such disparities are based on a number of factors, including Medicaid expansion status, race and ethnicity, occupation, and employment status. One overlooked disparity in coverage is the association between educational attainment and lack of insurance. Although the impact of education on earnings is well documented, our findings suggest that education continues to have an important impact on the likelihood of being uninsured, regardless of income level. We found substantial differences by educational level within each category of income. Specifically, lower levels of educational attainment are associated with higher rates of uninsurance in both the pre- and post-ACA periods. Furthermore, differences in rates of uninsurance by educational level have increased in the post-ACA period, indicating greater disparities based on educational attainment. Using data from the American Community Survey from 2013 and 2018, we calculated the percentage of adults ages 18-64 years old who were uninsured based on their educational attainment. We also stratified the data by three income categories: up to 100% of the federal poverty level (FPL), 100-399% FPL, and 400%+ FPL. Despite substantial reductions compared to 2013, those with incomes less than 100% FPL continued to have the highest rates of uninsurance in 2018 (Exhibit 1). In 2013, those without a high school or GED diploma had an uninsured rate that was 20 percentage points higher than the rate for those with a graduate degree. Although all groups improved by 2018, the percentage difference between those without a high school or GED diploma and those with a graduate degree actually increased compared to the pre-ACA period, indicating greater disparity. This finding suggests that relative changes in the rate of uninsurance, not just absolute percentage-point changes, are an important measure when examining disparities.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (3 unnumbered pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918351182806676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918351182806676