4.5 Article

Health Insurance For People Younger Than Age 65: Expiration Of Temporary Policies Projected To Reshuffle Coverage, 2023-33

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HEALTH AFFAIRS
卷 42, 期 6, 页码 742-752

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PROJECT HOPE
DOI: 10.1377/hlthaff.2023.00325

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According to the Congressional Budget Office, in 2023, there will be 248 million Americans under the age of 65 with health insurance coverage, majority of whom obtained it through employment-based plans. However, 23 million people in the same age group, accounting for 8.3% of the population, will remain uninsured, with variations in coverage related to income, race, and ethnicity. The temporary policies implemented during the COVID-19 pandemic have significantly contributed to the record-low uninsurance rate, but as these measures are phased out, millions of people are expected to transition to other forms of coverage or become uninsured.
The Congressional Budget Office estimates that in 2023, 248 million people in the US who are younger than age sixty-five have health insurance coverage (mostly through employment-based plans), and twenty-three million people, or 8.3 percent of that age group, are uninsured-with significant variations in coverage by income and, to a lesser extent, by race and ethnicity. The unprecedented low uninsurance rate is largely attributable to temporary policies that kept beneficiaries enrolled in Medicaid and enhanced the subsidies available through the health insurance Marketplaces during the COVID-19 pandemic. As the continuous eligibility provisions unwind in 2023 and 2024, an estimated 9.3 million people in that age group will transition to other forms of coverage, and 6.2 million will become uninsured. If the enhanced subsidies expire after 2025, 4.9 million fewer people are estimated to enroll in Marketplace coverage, instead enrolling in unsubsidized nongroup or employment-based coverage or becoming uninsured. By 2033 the uninsurance rate is projected to be 10.1 percent, which is still below the 2019 rate of about 12 percent.

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