Health insurance coverage and type among high-need New Yorkers Figure 6 Figure 6. Changes in insurance status and type among high-need New Yorkers
g Among the insured:
2021 2022
Public insurance Private insurance
98% 99%
20% 30% 40% 50% 60% 70% 80% 90% 100% 96% 20% 30% 40% 50% 60% 70% 80% 90% 100% 96% 2021 2022
100%
88%
98% 99%
88%
80%
67%
61%
60%
84%
85%
40%
39%
20%
33%
10% 0%
10% 0%
16%
15%
Economic disadvantage No economic disadvantage Economic disadvantage No economic disadvantage
0%
2021
2022
2021
2022
Source: Poverty Tracker longitudinal survey data; cohorts three and four. High-need refers to New Yorkers with high healthcare needs, such as multiple chronic health conditions, serious psychological distress, or a work-limiting health condition. Due to rounding procedures, some totals might not sum to 100. Note: The sample size for results on type of insurance is smaller than that of general insurance coverage, as not all Poverty Tracker respondents in this analysis were asked about their type of insurance. Private insurance defined as health insurance coverage from one’s own employer,
Economic disadvantage
No economic disadvantage
Most insured, high-need New Yorkers are covered by public health insurance, although economically dis- advantaged New Yorkers are more likely than the more-advantaged to be covered by public health insur- ance (85% vs 67% in 2022) (Figure 6). High levels of public insurance coverage for both groups in 2021 and 2022 is consistent with rising Medicaid enrollment and stabilization during that time, which helped offset declines in private coverage due to employment losses during the pandemic recession. 12 Nonetheless, giv- en their disproportionately high reliance on public health insurance, the economically disadvantaged are at further risk of losing coverage and access as the protections to Medicaid expired together with the pan- demic’s public health emergency in 2023. 13 Health insurance coverage is essential for receiving affordable and adequate care; however, access to health insurance is tied to income limits, employment status, and other eligibility requirements. In the box below, Kim, a high-need New Yorker, explains her experiences with changes to her health insurance, the consequences of losing coverage, and the precarity of securing affordable healthcare for her chronic conditions. someone else’s employer, COBRA, or another plan bought or owned. Public insurance defined as being covered by Medicaid, Medicare, or military insurance (including TRICARE, CHAMPUS, and Veteran’s Affairs), or some other source. Source: Poverty Tracker longitudinal survey data, cohorts three and four. High-need refers to New Yorkers with high healthcare needs, such as multiple chronic health conditions, serious psychological distress, or a work-limiting health condition. Due to rounding, some totals might not sum to 100. Note: The sample size for results on type of insurance is smaller than that of general insurance coverage, as not all Poverty Tracker respondents in this analysis were asked about their type of insurance. Private insurance defined as health insurance coverage from one’s own employer, someone else’s employer, COBRA, or another plan individually purchased. Public insurance defined as being covered by Medicaid, Medicare, or military insurance (including TRICARE, CHAMPUS, and Veteran’s Affairs), or some other source.
12 Lukens, Sullivan and Erzouki, “COVID relief provisions stabilized health coverage, improved access and affordability.”; Jacobs and Moriya, “Changes in health coverage during the COVID-19 pandemic.”; Benitez, “Comparison of unemployment-related health insurance coverage changes in Medicaid expansion vs non-expansion states during the COVID-19 pandemic.” 13 McIntyre et al., “Coverage and access changes during Medicaid unwinding.”
PATTERNS OF DELAYED HEALTHCARE AMONG NEW YORKERS WITH HIGH HEALTHCARE NEED 13
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