For working-age adults with disabilities, consistent access to health insurance may be critical to continuity of care and good health outcomes. We tracked changes in health insurance coverage for this population from 2010-2018. From 2010-11 to 2017-18, the proportion of U.S. adults with disabilities who lacked health insurance coverage for a full year was nearly halved, falling by about 46% from 17% to 9%. There was also an increase of about 14% in the proportion of adults with disabilities who had continuous coverage, from about 71% to 81%. These improvements were concentrated immediately after 2014, when the largest ACA-driven insurance expansions first took effect. Coverage gains were particularly large for Medicaid, coinciding with the ACA’s Medicaid expansion program that took effect in most states starting in 2014. Having coverage for only part of the year, however, remained more than 50% more common for adults with disabilities (10% in 2017-18) than those without disabilities (6% in 2017-18) throughout the study period. The American Rescue Plan of 2021 (ARP) expanded subsidies for Marketplace plans, which has the potential to increase coverage further for adults with disabilities. An estimated 532,000 uninsured adults with disabilities (about 67%) now have access to a zero-premium plan after premium tax credits on Healthcare.gov, an increase of 16.8 percentage points from pre-ARP estimates.
This brief was prepared through intramural research by the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability, and Aging Policy. For additional information about this subject, visit the BHDAP home page at https://aspe.hhs.gov/bhdap or contact the BHDAP authors at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201; Timothy.Creedon@hhs.gov, Helen.Lamont@hhs.gov, Judith.Dey@hhs.gov, William.Marton@hhs.gov.
The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted on July 28, 2021.