The percentage of uninsured Rhode Islanders dropped to 4.3 percent in 2016, down from 5.7 percent in the previous year and to less than half the rate before the Affordable Care Act went into effect. RI ranks 3rd best in New England and 6th best in the country.
Under the ACA, single adults with income slightly above the poverty level ($16,643) became eligible for Medicaid for the first time. This “Medicaid expansion” group comprises 23% of the 281,000 Rhode Islanders who benefit from Medicaid’s comprehensive health care coverage.
Families and individuals with income above the Medicaid limits can buy coverage through Health Source RI, the state’s health insurance exchange authorized by the ACA. Purchasers with income less than 400% FPL ($80,640 for a family of 3) receive tax credits to help pay the monthly premium. If income is below 250% FPL ($50,400, family of 3), the purchaser is also eligible for help paying for out of pocket expenses like deductibles and co-pays.
The majority of Rhode Islanders continue to have coverage through their employer, or purchase on their own, including people who buy through HSRI. Medicare provides coverage to people age 65 or older or who have been disabled for two years. Medicaid coverage is available to people whose income is below the applicable limit: children (266% FPL); pregnant women (258% FPL) parents (141% FPL); single adults (138% FPL); seniors and adults with disabilities (100% FPL). There is also a resource limit for seniors and adults with disabilities.
Although the percent of uninsured is dropping, the benefit of insurance coverage is not shared equally. While the overall rate of uninsurance is 4.3%, the rate for Whites Rhode Islanders is 2.9%; the uninsured rate among Latino residents is over three times that of Whites and for Black residents it is over double that of White residents.
Nationally, 8.6 percent of Americans were uninsured in 2016, down from 14.5 percent prior to the ACA, despite the fact that twenty states chose not to expand Medicaid to their low-income single residents. Had they done so, the number of uninsured Americans would be significant lower: the uninsured rate among “non-expansion” states was 11.7 percent, nearly double the 6.5 percent rate among states that expanded Medicaid.