Tuesday, May 09, 2017

The percentage of people without insurance has decreased in the past few years, thanks to the Affordable Care Act. The New York Times has mapped the percentage of uninsured in each county of the US, showing that in Pennsylvania, rates had fallen in 2014, but really decreased after the Medicaid expansion in 2015.

In Allegheny County, we see that the percentage of people between 18 and 64y age without insurance has decreased overall (graph below). We also see a decrease in the percentage of 19-25y olds who were uninsured--this is the age group that can stay on their parent's insurance under the ACA.

I mapped the proportion uninsured in each census tract using American Community Survey (ACS) five-year averages from 2012 to 2015. As you might expect, a decrease in the proportion uninsured was not apparent using five-year averages in these small geographic areas. Overall in the county, the five-year average for the percent uninsured in 2015 is 9.9%, which is nearly 3 percentage points above the 2015 ACS annual estimate of 7% uninsured apparent from the graph above.

So I aggregated the number uninsured in county council districts and calculated the proportion uninsured in these districts. This allows us to observe a decrease in the proportion uninsured in areas smaller than the entire county. The five-year average (2011-2015) washes out much of the decrease that might be apparent using an annual estimate--from a large survey, for example.

A map (below) of the decrease in the proportion of uninsured in council districts between 2012 and 2015 shows that the northern districts may have done a bit better than the eastern districts. 

If the ACA is not repealed in the Senate, we may have the opportunity in the future to examine whether spatial disparities in rates of insurance exist at finer geographic scales, revealing locations where people may need more assistance to sign up for coverage.

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