While private health insurance coverage remained steady in 2011, government enrollment increased and the overall uninsured rate fell from 2010, according to new figures released this week by the Census Bureau.

The percentage of uninsured Americans fell to 15.7 percent in 2011 to 16.3 percent in 2010. That coincided with the poverty rate remaining virtually unchanged at 15 percent and the household income average dropping by 1.5 percent to $50,054, the other metrics that the Census Bureau announced Wednesday.

About 64 percent of Americans were covered by private insurance, statistically unchanged from the previous year, the first time in 10 years that private coverage didn’t significantly decrease, the Census Bureau reported.

Meanwhile, government rolls went up to 32.2 percent in 2011 from 31.2 percent in 2010. Medicaid’s share of enrollment increased from 15.8 percent to 16.5 percent, while Medicare rose from 14.6 percent to 15.2 percent.

The overall uninsured figures and Medicaid numbers are likely to be referenced in the ongoing debate over the Affordable Care Act (ACA). For example, Texas—where Gov. Rick Perry and his administration have expressed firm opposition to the law’s 2014 Medicaid expansion, which is now optional after the Supreme Court ruling in June—continued to post the highest uninsured rate in the country at 24.6 percent. Florida (20.7 percent), South Carolina (18.8 percent) and Louisiana (18.4 percent) also ranked among the 10 states with the most uninsured, and their governors have said they oppose the Medicaid expansion, according to a compilation of governor positions from MSNBC.

As Governing has previously reported, some speculate that those states, while initially defiant, would not be able to resist the windfall of federal money that would come with the expansion. There is also likely to be pressure from health-care providers, particularly hospitals, which stand to lose money if people remain uninsured. Meanwhile, opponents to the ACA are putting their hopes in GOP presidential nominee Mitt Romney, who has said he would repeal the law if he were elected.

“Implementation of health reform’s major coverage provisions in 2014 should generate much greater progress in reducing the ranks of the uninsured,” wrote Matt Broaddus and Edwin Park, analysts at the liberal Center for Budget and Policy Priorities, in response to the Census report. “If many states turn down the expansion, however, progress in covering low-income people who now are uninsured… will be substantially smaller.”

Massachusetts—where Romney signed the 2006 health-care reform bill that is widely seen as the predecessor of the ACA—had the lowest uninsured rate in the nation at 4.4 percent.

The Obama administration and supporters of the ACA had another talking point from the Census figures: the percentage of uninsured adults ages 19 to 25 declined by 2.2 percent from 2010 to 2011, by far the largest drop of any age group. The federal health-care reform law included a provision that allows children to stay on their parents’ insurance plan until age 26.

View the table below for uninsured rates for all 50 states.


 

           
State 2008-09 Percentage 2008-09 Conf. Interval 2010-11 Percentage 2010-11 Conf. Interval Change in Percentage
United States 15.5 0.2 16.0 0.2 0.5
Alabama 14.0 1.3 14.3 1.9 0.3
Alaska 18.4 2.0 18.2 1.6 -0.2
Arizona 19.0 1.9 18.2 1.4 -0.8
Arkansas 18.3 1.4 18.0 1.7 -0.3
California 18.7 0.6 19.6 0.6 0.8
Colorado 14.9 1.1 14.3 1.2 -0.6
Connecticut 10.2 1.0 9.9 1.0 -0.3
Delaware 11.9 1.2 10.7 1.1 -1.2
District of Columbia 10.9 1.3 10.6 1.2 -0.3
Florida 20.6 1.0 20.2 1.0 -0.3
Georgia 18.8 1.4 19.3 1.5 0.5
Hawaii 7.3 0.8 7.8 0.8 0.4
Idaho 15.3 1.9 18.0 2.3 2.8
Illinois 13.2 1.0 14.8 1.0 1.6
Indiana 12.5 1.2 12.7 1.2 0.2
Iowa 9.9 1.0 11.1 1.2 1.2
Kansas 12.3 1.6 13.1 1.4 0.8
Kentucky 15.8 1.4 14.6 1.7 -1.2
Louisiana 17.0 1.4 20.3 1.5 3.3
Maine 10.1 1.0 9.7 1.1 -0.4
Maryland 12.3 1.2 13.3 1.2 1
Massachusetts 4.6 0.7 4.5 0.6 -0.2
Michigan 12.2 1.0 12.7 0.9 0.5
Minnesota 8.1 1.0 9.5 0.8 1.3
Mississippi 17.5 1.9 18.6 1.7 1.1
Missouri 13.5 1.2 14.4 1.9 0.9
Montana 15.4 1.8 18.2 1.5 2.8
Nebraska 11.1 1.0 12.8 1.1 1.7
Nevada 19.3 1.5 22.0 1.6 2.7
New Hampshire 10.0 0.9 11.3 1.0 1.4
New Jersey 13.9 1.2 15.5 1.2 1.7
New Mexico 21.9 2.9 20.5 2.4 -1.4
New York 13.8 0.7 13.6 0.7 -0.1
North Carolina 16.5 1.2 16.7 1.3 0.2
North Dakota 10.9 1.9 11.3 1.7 0.3
Ohio 12.5 1.0 13.7 0.9 1.2
Oklahoma 15.9 2.1 17.1 1.6 1.2
Oregon 16.6 1.3 14.9 1.3 -1.7
Pennsylvania 10.3 0.8 10.9 1.0 0.6
Rhode Island 11.5 1.2 11.8 1.1 0.2
South Carolina 16.2 1.5 19.7 1.9 3.6
South Dakota 12.6 2.0 13.0 1.4 0.4
Tennessee 14.7 1.3 13.9 1.2 -0.8
Texas 25.0 1.1 24.2 1.0 -0.8
Utah 13.0 1.4 14.2 1.4 1.2
Vermont 9.4 1.0 9.0 1.1 -0.4
Virginia 12.2 1.0 13.7 1.1 1.5
Washington 12.3 1.2 14.2 1.4 1.9
West Virginia 14.1 1.3 14.2 1.3 0.0
Wisconsin 9.1 1.1 9.9 1.3 0.8
Wyoming 14.3 1.5 17.5 1.3 3.2

The intervals (+/-) shown measure an estimate's variability at 90 percent confidence. Some totals for change in percentage may not sum because of rounding.