Health insurance remains a relevant and politicized topic in the United States. The number of people with health insurance in the U.S. was over 300 million in 2022, about 92 percent of the population. The health system in the country is a mix of both public and private insurers, but private is the main form of health insurance coverage among the U.S. population. In 2022, over half of the people with health insurance received private insurance through their employer, while over 36 percent were covered under the public insurance programs Medicare and Medicaid. Because the U.S. does not have universal health insurance coverage, millions of people remain uninsured every year. Public opinion on a Medicare-for-all health plan remains divided, but there is marginally more support for a single-payer system.
The percentage of the U.S. population covered by private health insurance has more or less remained steady since 2015. Under employer-sponsored private coverage, both the employer and the employee usually contribute to premiums or the amount to be paid each month. In 2023, the average annual deductible for employer-sponsored health insurance was 1,735 U.S. dollars. A deductible is the amount an individual pays for health care services before the insurance company starts to pay. Employers usually purchase health plans for employees from private health insurance companies. The largest health insurance companies in the United States by revenue are UnitedHealthcare Group, CVS health and McKesson..
The main public health insurance programs in the United States are Medicare and Medicaid. Medicare provides health insurance for the elderly and those with disabilities, while Medicaid focuses on providing coverage for low-income families. In 2022, around 37 percent of the U.S. population received health insurance through Medicare and Medicaid. As enrollment in both public health programs has grown, so has spending, with total Medicaid expenditure exceeding 800 billion U.S. dollars in 2022. Total Medicare spending has seen a drastic increase in the past decade, reaching over one trillion U.S. dollars in 2023. Medicare and Medicaid, as well as other public insurance plans, are funded through federal taxes. Other public health insurance plans include the Children’s Health Insurance Plan (CHIP), which provides health coverage to children through Medicaid as well as separate programs, and military insurance programs such as the Veterans Health Administration.
The percentage of people without health insurance in the U.S. was 8.4 percent in 2022, which translates to around 30 million people. The share of Americans without health insurance dropped following the enactment of the Affordable Care Act (ACA), also known as Obamacare. In recent years, however, the uninsured rate has risen again after the repeal of the individual mandate that required most citizens to have health insurance. The states with the highest share of people without health insurance are Texas, Oklahoma, and Georgia. In Texas, 16.6 percent of the population did not have health insurance in 2022, which was twice the national average.
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