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|
John W Beck, PhD | |
Target Metrics | ||||||
|
Metric |
Actual (%) |
Target |
Best Countries |
Notes |
||
|
2024 |
2025 |
2026 |
UHC |
Current |
||
|
Health Coverage |
||||||
|
Insured Rate: |
92.0 |
91.7 |
91.3 |
≥ 99.5 |
99.9 |
2024 Census CPS ASEC; 2025–26 insured-share projection from CMS NHE projections. |
|
Uninsured Rate: |
8.0 |
7.9 |
9.0 |
≤ 0.5 |
≤ 0.1 |
2024 Census CPS ASEC; 2026 rise aligns with CMS projections showing coverage decline after subsidy expiration dynamics. |
|
Underinsured Rate (adults 19-64): |
23.0 |
23.0 |
24.0 |
≤ 5.0 |
3*** |
Commonwealth Fund (2024 Biennial): ~23% of insured working-age adults underinsured; 2026 risk increases if affordability worsens. |
|
Private Coverage: |
66.1 |
66.0 |
65.0 |
NA |
NA |
2024 CPS ASEC; modest decline risk in 2026 tied to projected individual-market ("direct purchase") contraction. |
| Employment Based: |
53.8 |
54.0 |
54.0 |
NA |
NA |
2024 CPS ASEC. Employer coverage projected roughly stable in CMS NHE enrollment outlook. |
| Direct Purchase: |
10.7 |
11.0 |
9.0- 10.0 |
0 - 10% |
NA |
2024 CPS ASEC; CMS NHE projects direct-purchase enrollment falling in 2026. |
| Catastrophic Health Spending Rate: |
25.3 |
TBD |
TBD |
≤ 1.0 |
NA |
High medical expense burden = medical expenses >10% of post-tax & transfer income (SPM family, CPS ASEC). |
|
Public Coverage: |
35.5 |
35.5 |
35.5 |
NA |
NA |
2024 CPS ASEC; Medicare grows gradually; Medicaid stabilizes post-unwinding. |
| Medicare: |
19.1 |
19.5 |
19.5 |
NA |
NA |
2024 CPS ASEC; CMS NHE shows Medicare enrollment rising through 2026. |
| Medicaid: |
17.6 |
17.5 |
17.5 |
NA |
NA |
2024 CPS ASEC; CMS NHE shows Medicaid enrollment roughly stable 2025-26. |
| ACA: |
--- |
24.3M |
23M |
≤ 5M |
NA |
2025 total plan selections reported by CMS/KFF; 2026 enrollment reported/proj. ~23M amid affordability changes. |
|
Military Coverage: |
2.8 |
2.8 |
2.8 |
2.8 |
NA |
2024 CPS ASEC; assumed stable absent structural changes. |
|
Key Trends and Demographics (Uninsured) |
||||||
|
Adults Age 19-64: |
11.0 |
11.0 |
12.0 |
≤ 0.7 |
0.1 |
2024 CPS ASEC baseline; 2026 increase consistent with higher overall uninsured in CMS projections. |
|
Children <19 yrs old: |
6.1 |
6.0 |
6.5 |
≤ 0.5 |
NA |
2024 CPS ASEC baseline; mild drift assumption. |
|
Medical Debt Prevalence: |
36.3* |
TBD |
TBD |
≤ 2 - 3 |
--- |
People with medical debt in collections or reporting difficulty paying medical bills. |
|
Medical Debt in Collections / on Credit Reports: |
15M 4.1% ** |
TBD |
TBD |
0.0 |
--- |
Two complementary "collections" lenses: CFPB (people/balances) and Urban (credit-record prevalence). |
|
Cost-related Access Problems: |
41 |
41 |
41 |
--- |
17 |
From Commonwealth Fund - Mirror, Mirror 2024 - Appendix (10-country comparison). Best: Germany 17%. |
|
Insurance Denied Payment / Paid Less Than Expected: |
32 |
32 |
32 |
--- |
3 |
Same Appendix. Best among your list: UK 3%. (Useful proxy for underinsurance/coverage adequacy across countries.) |
|
Serious Problems Paying or Unable to Pay Medical Bills (adults): |
22 |
22 |
22 |
--- |
4 |
Same Appendix. |
|
Our-of-Pocket Medical Bills > $1K: |
41 |
41 |
41 |
--- |
8 |
Same Appendix. UK 8%. (Proxy for catastrophic cost exposure in cross-country survey data.) |
|
Marketplace Plan Selections (millions): |
21 |
24.2 |
23 |
--- |
NA |
2024 ~21M cited by Commonwealth Fund; 2025 KFF reports ~24.2M; 2026 Reuters reports ~23M. |