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Research Questions

  1. What is the current status of health insurance enrollment in Connecticut by age, gender, race, and ethnicity?
  2. How was enrollment affected during the early months of the COVID-19 pandemic?

The state of Connecticut is considering a number of policy options to improve health insurance affordability, access, and equity. To create policies designed to increase insurance coverage and access to care in underserved communities and reduce racial and ethnic disparities, state policymakers need an accurate picture of the current distributions of insurance enrollment across these dimensions.

The authors combine data from the American Community Survey Public Use Microdata Sample, which includes demographic characteristics, as well as insurance status, with various data sources from the state to provide a fuller picture of insurance enrollment among those under the age of 65 in Connecticut. They also use existing high-level estimates of 2020 insurance enrollment to provide estimates of how enrollment in the state was affected during the early months of the pandemic.

The authors find that insurance enrollment in Connecticut in 2019 was generally high but that there were substantial differences in insurance coverage by race and ethnicity. Asian individuals had the highest rates of employer-sponsored insurance coverage, and Black individuals had the highest rates of Medicaid coverage. Hispanic individuals had a higher rate of Medicaid coverage than non-Hispanic individuals. High-level estimates of changes in insurance coverage during the early months of the COVID-19 pandemic suggest that uninsurance decreased slightly, Medicaid coverage increased, and private insurance coverage fell.

This report provides the state of Connecticut with estimates of enrollment in detailed health insurance categories by age, gender, race, and ethnicity and highlights the need for better, more-detailed health insurance enrollment data.

Key Findings

Health insurance enrollment in Connecticut was generally high

  • In 2019, 93.5 percent of the population was enrolled in health insurance.
  • Younger individuals—especially those under the age of 18—had the highest rate of coverage by Medicaid compared to other age groups.
  • ESI covered the largest proportion of individuals within each age category, but was highest among those ages 40–49; over two-thirds of that population was enrolled in ESI.
  • Within the individual market, younger people were more likely to have off-marketplace coverage.
  • High-level estimates of the changes in insurance enrollment in Connecticut between 2019 and 2020, which includes the early months of the COVID-19 pandemic, suggest that uninsurance decreased slightly, Medicaid coverage increased, and private insurance coverage fell.

There were substantial differences in insurance coverage by race and ethnicity

  • Asian individuals had the highest rate of ESI coverage (76.0 percent), compared with 64.0 percent of white individuals, 52.8 percent of black individuals, and 45.4 percent of those of other races.
  • Medicaid coverage was highest among Black individuals (34.7 percent).
  • Within the individual market, subsidized enrollment was highest among those who are white or of another race (46.6 percent and 55.2 percent, respectively), while 30.8 percent of black enrollees and 35.2 percent of Asian enrollees on the individual market received subsidies.
  • Considering differences by ethnicity (Hispanic versus non-Hispanic), Hispanic individuals had a substantially higher rate of coverage by Medicaid (35.7 percent) compared with non-Hispanic individuals (19.4 percent).

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Methods

  • Chapter Three

    Results

  • Chapter Four

    Discussion

  • Appendix

Research conducted by

This research was jointly funded by Arnold Ventures and the Commonwealth Fund and was carried out within the Payment, Cost, and Coverage Program in RAND Health Care.

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