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Gaps Persist Despite Gains in Health Insurance Coverage

State of Working of Oregon Series
March 15, 2016 Download PDF

Some communities of color and low-income adults — especially young adults — still face significant barriers to gaining health insurance in Oregon. Analysis of the most recent U.S. Census data shows that tens of thousands of previously uninsured Oregonians gained health insurance in 2014 as a result of the Affordable Care Act and Oregon’s Medicaid expansion. Still, gaps in coverage remain particularly large for certain populations.

An estimated 191,000 previously uninsured Oregonians gained health insurance in 2014.[1]

This followed the expansion of Oregon’s Medicaid program — the Oregon Health Plan — to more low-income adults and the creation of a private health insurance marketplace for Oregonians with higher incomes.

As a result, 90.3 percent of Oregonians were insured in 2014, a jump from 85.3 percent the previous year.


Some 381,000 Oregonians remained uninsured in 2014.[2]

That was more than the number of people who lived in the cities of Eugene, Corvallis and Salem, combined.[3]



Working-age Oregonians were, by far, the largest beneficiaries of health reform measures.

Health insurance coverage for Oregonians between the ages of 18 and 64 increased from 78.8 percent in 2013 to 86.1 percent in 2014.

The share of children and senior Oregonians with health insurance remained considerably higher.


The lack of health insurance is particularly high among young adult Oregonians.

In 2014, about 20.2 percent of Oregonians between the ages of 25 and 34 lacked health insurance — the highest of any age group.

The next highest group was 18 to 24 year-olds, of whom 14.8 percent lacked insurance.


Oregonians with low incomes face the greatest barriers to coverage.

In 2014, 23.7 percent of Oregonians with incomes between 138 and 200 percent of the federal poverty level lacked health insurance. Many of these individuals would have been eligible for marketplace coverage.

Oregonians with even lower incomes were also often uninsured in 2014, at a rate of 22.9 percent.


While most racial and ethnic groups in Oregon gained health insurance coverage in 2014, disparities persist for some communities of color.[4]

Eighteen percent of Hawaiian and Pacific Islanders still lacked health insurance in 2014, as compared to 7.8 percent of whites.

Similarly, 21.4 percent of Latinos and 21.5 percent of American Indian and Alaska Natives were uninsured that year.


The vast majority of Oregonians lacking health insurance are United States citizens.

In 2014, 78.1 percent of Oregon’s uninsured were United States citizens.

This was a modest drop from 2013, when citizens made up 81.8 percent of the uninsured.

Conclusion

Health reforms implemented in 2014 succeeded in extending health insurance coverage to tens of thousands of previously uninsured Oregonians, but the work is not done. Many Oregonians — particularly low-income working-age adults, young adults and certain communities of color — remain uninsured.

Note on Methodology

Like all surveys, the American Community Survey (ACS) — the source of data for this analysis — provides estimates from a random sample of households. These estimates have a margin of error: results will vary from one sample to another to a certain extent, depending on sample size and the particular characteristic that is being measured.

When comparing two measures — for instance, the uninsured rates in two different years or among two different racial groups — it is important to consider how this sampling variability affects the difference between the two measures. If the difference between the two rates would occur due to variability less than 10 times out of 100, then we can say that we have a 90 percent level of confidence that the difference between the two rates reflects an actual difference. In other words, the chance that the difference between the two estimates is simply the result of random chance is less than 10 percent. While different levels of confidence (e.g., 95 or 99 percent) can be used to measure significance, the 90 percent level is typically used when analyzing ACS data, and that is the level used here when establishing whether a difference is significant.


[1] All data in this fact sheet is derived from the American Community Survey of the U.S. Census, unless otherwise noted.

[2] The American Community Survey estimates the number of uninsured in Oregon in 2014 to be 381,337.

[3] The Portland State University Population Research Center estimates that in 2014 the population of Eugene was 160,775, the population of Corvallis was 56,535 and the population of Salem was 159,265.

[4] Between 2013 and 2014, the uninsured rate for whites dropped from 12.4 percent to 7.8 percent, for Latinos from 29.2 percent to 21.4 percent, for African-Americans from 16.4 percent to 9.3 percent and for Asians from 12.7 percent to 8.6 percent. The difference in uninsured rates between 2013 and 2014 for American Indian/Alaska Natives of 22.0 percent and 21.5 percent respectively was not statistically significant. The difference between the uninsured rates between the same years for Hawaiian/Pacific Islanders of 22.8 percent to 18.0 percent also was not statistically significant.