Trends in Health Insurance, 2013 to 2017

How has health insurance coverage changed with the implementation of the Affordable Care Act? Surprisingly, it hasn't changed all that much. Most Americans get their health insurance through an employer (either their own employer or a spouse's or parent's employer). The percentage of the population with employer-provided health insurance in 2017 was identical to the percentage who had it in 2013—before most provisions of the ACA went into effect. Here is the distribution of the population by type of health insurance in 2017 and the trend since 2013...

• 56.0% of the population has employment-based health insurance, nearly identical to the 55.7 percent of 2013.
• 19.3% of the population has Medicaid coverage, higher than the 17.5 percent of 2013 because of the ACA's Medicaid expansion.
• 17.2% of the population has Medicare coverage, higher than the 15.6 percent of 2013 because the large baby-boom generation is filling the 65-plus age group.
• 16.0% of the population has direct-purchase health insurance, up from 11.4 percent in 2013. Behind the increase are the ACA's marketplace plans, providing access to health insurance for millions who were once shut out because of preexisting conditions or price. The number of people with direct-purchase health insurance grew by 16 million between 2013 and 2017— a 45 percent increase and the single biggest change in health insurance coverage during the time period.
• 4.8% of the population has military coverage, up from 4.5 percent in 2013.
• 8.8% of the population had no health insurance at any time during 2017, down from 13.3 percent who were without health insurance in 2013. The number of people without health insurance fell by 13 million during those years, a 32 percent decline. 

Note: The percentage of the population with health insurance by type sums to more than 100% because some people have more than one type of coverage.
Source: Census Bureau, Current Population Survey Tables for Health Insurance Coverage