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NCHS Data on Health Insurance and Access to Care

NCHS Factsheet, November 2015

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About NCHS

The National Center for Health Statistics (NCHS) is the nation’s principal health statistics agency, providing data to identify and address health issues. NCHS compiles statistical information to help guide public health and health policy decisions.

Collaborating with other public and private health partners, NCHS uses a variety of data collection mechanisms to obtain accurate information from multiple sources. This process provides a broad perspective on the population’s health, influences on health, and health outcomes.


Health Insurance and Access to Care

Health insurance coverage is a major determinant of access to health care. Uninsured children and nonelderly adults are substantially less likely to have a usual source of health care or a recent health care visit than their insured counterparts. The majority of persons under age 65 have coverage through private employer-sponsored group health insurance. Private health insurance may also be purchased on an individual basis. In 2014, U.S. adults could buy a private health insurance plan through the Health Insurance Marketplace or state-based exchanges established as part of the Affordable Care Act. Moreover, some states opted to expand Medicaid coverage to low-income adults.


Health Insurance Data

NCHS’ National Health Interview Survey (NHIS) collects three measures of lack of health insurance coverage: currently uninsured, uninsured at least part of the year, and uninsured for more than a year. In 2014, insurance coverage estimates were also available for all states and the District of Columbia. The percentage of persons under age 65 who were uninsured at the time of interview ranged from 2.5% uninsured in Hawaii to 21.5% uninsured in Oklahoma and Texas. Data from the 2013 and 2014 NHIS are used to describe recent changes in health insurance coverage and selected measures of health care access and utilization for adults aged 18–64, by race and Hispanic origin.

NHIS data on uninsured adults aged 18–64 by race and ethnicity for 2013 and 2014 show:

  • Compared with 2013, the percentage of adults aged 18–64 who were uninsured at the time of interview decreased in 2014 for Hispanic (41.1% to 34.1%), non-Hispanic white (14.5% to 11.5%), non-Hispanic black (24.7% to 17.6%), and non-Hispanic Asian (16.1% to 12.1%) adults.

NHIS data on health insurance coverage for adults aged 18–64 for 1997–2014 show:

  • The percentage of adults aged 18–64 who were uninsured at the time of interview generally increased between 1997 and 2010.
  • More recently, the percentage of uninsured has decreased, from 22.3% in 2010 to 16.3% in 2014. During this 4-year period, corresponding increases were seen in both public and private coverage among adults aged 18–64.


Figure 1 is a line graph showing the percentage of adults aged 18 through 64 who were uninsured or had private or public coverage at the time of interview for 1997 through 2014.

SOURCE: CDC/NCHS, National Health Interview Survey, 1997–2014.


Access to Care Data

Clinical experts note that with access to timely and appropriate ambulatory care, patients may be able to prevent illness, control acute episodes, or manage chronic conditions to avoid exacerbating or complicating those conditions. Although health insurance coverage levels provide a strong indication of Americans’ access to health care, other measures enhance understanding of this issue and point to solutions to improve access.


Usual place to go for medical care

Data from the 2013 and 2014 NHIS show:

  • Compared with 2013, the percentage of adults aged 18–64 who had a usual place to go for medical care increased in 2014 for Hispanic (69.1% to 73.0%) and non-Hispanic white (84.3% to 85.6%) adults.
  • The percentage of non-Hispanic black and non-Hispanic Asian adults aged 18–64 who had a usual place to go for medical care did not change significantly from 2013 to 2014.


Figure 2 is a map showing the percentage of office-based physicians by state who were accepting new Medicaid patients in 2013.

SOURCE: CDC/NCHS, National Health Care Surveys, National Health Records Survey, 2013.


Office-based Physician Practices

Data from NCHS’ National Health Care Surveys can provide insights into access to care. The percentage of physicians accepting new patients—which varies by type of payment—helps measure physician capacity to meet increased demand. Data in 2013 show:

  • The majority of physicians reported that they accepted new patients with private insurance (85%), compared with 70% who accepted new patients with Medicaid.
  • Twenty-five states had higher physician acceptance rates for new Medicaid patients than the national average (70%).
  • Physician acceptance rates for Medicaid patients were lower than the national average in four states. A previous study using NCHS data found that higher state Medicaid-to-Medicare fee ratios were correlated with greater acceptance of new Medicaid patients.


Health Insurance and Access to Care Data Sources

  • National Health Interview Survey—Collects information on the nation’s health through personal household interviews that measure health status and disability, selected conditions, insurance coverage, access to care, use of health services, immunizations, health behaviors, injury, and the ability to perform daily activities. For more information, visit the NHIS website.
  • National Health Care Surveys—A family of health care provider surveys that together obtain information about the facilities that supply health care, services rendered, and characteristics of the patients served. Sites surveyed include: hospitals, office-based physician practices, emergency and outpatient departments, ambulatory surgery centers, nursing homes, and home health and hospice agencies. For more information, visit the NHCS website.

For further information about NCHS and its programs, visit NCHS website,