Unlimited access to high-quality health care represents one of the biggest challenges our world currently faces. While there are numerous ways to go about ensuring access to health-related services, health insurance is likely the most popular at this point in time.
With this in mind, the main purpose of these health insurance statistics is to outline the numbers and facts concerning the health insurance industry. Doing so should make it easier to identify and solve current challenges and create a better insurance system for everyone. This article covers a variety of topics, including but not limited to insurance profits, enrollment rates, fraud, and claim denial. Additionally, the statistics include several countries, with a focus on the US.
Health Insurance Statistics- 2020
- 9.4% of Americans were uninsured in 2018, thus leading to staggering health care costs in case of a medical emergency.
- On a yearly basis, roughly 4% of uninsured Americans are forced to declare bankruptcy due to overwhelming health care costs.
- 40%–50% of US residents rely on employer health insurance.
- New York is known for having the highest health insurance rates, whereas New Mexico has the lowest.
- In the US, it’s estimated that insurance fraud leads to costs of over $80 billion on a yearly basis. It’s unclear how much of the pie is owned by health insurance fraud specifically.
US Health Insurance Statistics
1. Roughly 21% of Americans were insured by Medicare in 2019.
This totals roughly 72 million Americans. The numbers have definitely changed a bit since then, yet they show that insurance enrollment within the US is far from reaching an optimal rate. Millions of people remain uninsured, thus bringing along massive debt that’s difficult to repay. In fact, studies have also indicated that health care represents one of the leading causes of poverty within the US, alongside smoking, drugs, mortgages, and education.
2. In 2019, 9.2% of Americans were uninsured.
In other words, in the unfortunate case of an accident or disease, 9.2% of Americans will have to pay the full cost out-of-pocket, according to the health insurance statistics. Health care costs in the US are already sky-high when compared to other regions of the world.
3. 4% of Americans are forced to declare bankruptcy due to unpaid medical bills.
High insurance costs, low income, and huge medical expenses lead to bankruptcy. This is currently the case for over 4% of US residents.
Source: New England Journal of Medicine
4. By 2026 in the US, the health insurance statistics and data indicate that the hospital insurance trust fund may become depleted.
This will make it even harder for uninsured Americans to get access to quality health care. Experts are hopeful that a new hospital insurance trust fund will be reinstated, to ensure all expenses are covered.
Source: Jama Network
5. Private health care plans are seeing an increase in popularity, as the number of people enrolled has tripled since 2004.
This statistic helps underline a critical fact. While public health insurance is available, many Americans see it as insufficient, thus choosing to opt for private plans. Despite being more expensive, private health care plans usually offer access to quicker and better health care when compared to public-run hospitals.
Source: 2018 Medicare Trustees Report
Health Insurance Statistics by State
6. On a state-wide level, 40%–50% of US residents rely on employer health insurance.
In a study carried out in 2013, the percentage of residents relying on employer health insurance was calculated. As such, states like Colorado, Connecticut, Delaware, Iowa, Kansas, Maryland, Massachusetts, Minnesota, North Dakota, and Wisconsin had some of the highest rates (all above 50%).
7. Texas, Oklahoma, Georgia and Florida had the highest percentage of uninsured Americans in 2019.
This showcases how essential it is for governments to figure out ways to make sure that more people are insured in these areas.
Health Insurance Profits and Statistics
8. In 2017, the top US health insurance companies made roughly $6 billion in profits.
This also upped their stock prices. Higher profits for insurance companies means they tend to rely more on actual payments made by clients, rather than government-sponsored incentives.
9. An illness that entails intensive care for a prolonged period generally brings medical bills of over $1 million.
It’s difficult to imagine having to pay over $1 million because of a disease that nobody has any control over. However, this is the unfortunate case within the US health care system, thus showcasing why insurance is mandatory. Similarly, another study shows that hospitals overcharge Americans by roughly $10 billion on a yearly basis.
Source: Business Insider
Mental Health Insurance Coverage Statistics
10. Health insurance statistics show that the US state of Massachusetts ranks first for access to mental health care, whereas Mississippi is last.
This study covered the number of adults with mental health conditions who didn’t receive treatment, in some cases because of the general poor availability of a mental care workforce. There were also those who reported an unmet need, were uninsured, or weren’t able to see a doctor because of the large costs.
Source: MHA National
Health Insurance Claim Denial Statistics
11. Over 19% of the insurance claims submitted via in-network services in 2017 were denied by insurers.
This statistic sheds some light on claim denial by US health insurers, which seems to be quite prevalent. It is, however, important to mention that denial rates are based on a series of factors, including the medical conditions stipulated in the contract, alongside health care availability and funding.
Health Insurance Industry Employment Statistics
12. In 2018 health insurance statistics data, the number of health insurance home-office employees reached 528,000 in the US.
This is representative of a general growth trend, granted that the first studies in this regard were carried out back in 1960. While 2018 marks the largest number of employees so far, there is still no data for 2020 where it is expected that this statistic reaches it all-time high.
13. In the US, it’s estimated that insurance fraud leads to costs of over $80 billion on a yearly basis.
This trend has caused over 49% of US adults to worry over the safety of their health care data, considering that medical identity theft is becoming a country-wide problem.
Source: Insurance Fraud
14. 22% of Americans are worried that health insurance fraud can lead to having their policies canceled by insurers.
At this time, the tools designed to recover stolen medical identities are still in their infancy. Meanwhile, the need for fraud protection is constantly growing bigger.
Source: Insurance Fraud
Health Insurance Cost Statistics
15. Roughly 800 million people worldwide spend 10% of their household budget on health care.
The study concluded that half of the world’s population lacks essential and basic health care services. While the world’s population has increased exponentially, the prevalence of health care is still far behind.
Health Insurance Enrollment Statistics
16. Between 2014 and 2019, a total of 11.4 million Americans selected a Marketplace health insurance plan.
These plans were purchased thanks to the Affordable Care Act’s Health Insurance Marketplace, which allows US residents to buy insurance during an established open enrollment period.
Based on everything that has been outlined here, several points are worth noting. First, health insurance is necessary to ensure that an unexpected disease or accident doesn’t lead to impoverishment. On the other hand, insurance premiums remain fairly low, but costs are continuing to increase. This shows that additional regulation is necessary to ensure that the main goal of health insurance providers is to help the needy, rather than to get higher profits. Second, health insurance statistics indicate that health care worldwide remains underdeveloped—hundreds of millions of people lack access to basic health care services.
In the future, it’s essential for political leaders and civil society to focus on making affordable, high-quality health care a reality for people throughout the world. Failure to do so will impede the efforts to extend life expectancy and potentially lead to the appearance of more diseases that can’t be treated.