Survey: Rhode Island Sustains Low Uninsured Rate

2024 data suggests possible further improvement upon 2022’s celebrated success 

PROVIDENCE – Analysis of the latest Rhode Island Health Information Survey (HIS) conducted on behalf of HealthSource RI (HSRI), Rhode Island’s state-based health coverage marketplace, shows that just 2.2% of Rhode Islanders are estimated to be uninsured, a reduction from 2.9% the last time this survey was conducted in 2022. While this reduction is within the margin of error, the recording of an uninsured rate under 3%” is encouraging, particularly during a time period that saw the return to annual renewals for Medicaid customers, a potential disruption to coverage that Rhode Island leaders worked diligently to guard against. With this progress, Rhode Island proudly remains near the top in national rankings of the states with the lowest uninsured rates. Recently released federal data from 2023 bears this out, though using different methodology that makes direct comparison with the HIS difficult.

“Ensuring access to high-quality, affordable health care is key to ensuring that Rhode Island and its people remain strong and successful,” said Governor Dan McKee. “An integral part of that is the health coverage that protects from unexpected costs and allows individuals and families to take advantage of regular preventative care. I’m proud that even through the reintroduction of the annual Medicaid renewal process at the end of the pandemic, Rhode Island has done a remarkable job of keeping its citizens covered and even achieved its lowest ever uninsured rate.”

HealthSource RI has served nearly 161,000 Rhode Islanders since its inception in 2013, roughly mirroring the proportion of 1 in 7 Americans, about 50 million individuals, served by state and federal exchanges nationwide.  HSRI’s role in connecting Rhode Islanders to coverage has been booming in recent months, with enrollment swelling to an all-time high of more than 46,000 in its individual and family plan offerings, and an additional 8,200 lives covered through its small employers arm serving local businesses and non-profits with access to group plans. An automatic enrollment and premium support program introduced by Governor McKee and supported with legislative action kept almost 11,000 customers transitioning from Medicaid connected to coverage through HSRI, providing a cushion to those in income brackets just above Medicaid eligibility. Almost 6,000 more outside of those programs enrolled in coverage through HSRI, nearly all benefitting from federal subsidies that are at an all-time high through enhancements created by the American Rescue Plan Act (ARPA) of 2021 and extended via the Inflation Reduction Act (IRA) of 2022. Those enhancements are set to expire at the end of 2025 without further Congressional action.

“This incredible rate of near-universal coverage for Rhode Island is a mark of the maturing of our state-based marketplace, built for and tailored to the needs of Rhode Islanders,” said Lindsay Lang, Director of Health Source RI. “HSRI has been collaborating more closely than ever with our partners at Medicaid to ensure continuity of coverage for thousands, our small employer services continue to grow and meet the needs of the state’s businesses and nonprofits, and increasingly families and individuals look to us for their coverage needs. We value the results of this and other surveys as we refine and grow our operations, outreach and tools available to keep Rhode Islanders connected to high-quality, affordable coverage.”

The HIS provides leaders with some key learnings about the approximately 24,000 Rhode Islanders who remain uninsured, information that will be actionable in the state’s ongoing efforts to boost awareness of and access to the spectrum of health coverage options available to Rhode Islanders:

• Only 0.2% of children 17 and younger remain uninsured.
• Young adults 18-25 are improving their rate of coverage, with only 3.5% uninsured, continuing a 12-year downward trend. Their next older peer group, from ages 26-35, also trends in the right direction with 6.4% uninsured, down from 7.6% in the 2022 survey and a baseline high of 26% in 2012.
• Those 45-64 are highly likely to be covered, boasting a 1.8% uninsured rate.
• Males are more likely than females to be uninsured, with 3.5% of males vs 1.1% of females uninsured.
• Employment status does not necessarily assure coverage status – those who are employed full-time are no more likely to be covered than the general population; in fact, 3.9% of those working full-time and 2.9% of part-time workers are uninsured.
• Disparities persist based on race, ethnicity and birthplace, trends that HSRI and other state health leaders have been grappling with over time:
  • 1.3% of white, 4.1% of black, 2.5% and of Asian Rhode Islanders are uninsured;
  • 7.1% of the Hispanic population are uninsured vs. 1.2% of the non-Hispanic population;
  • 1.3% of those born in the U.S. are uninsured vs. 8.8% of those born elsewhere.
• Underinsurance, inadequate coverage that can cause financial hardship because of high out-of-pocket costs, continues to surface as an issue for more than a quarter of Rhode Islanders.

The HIS has been surveying Rhode Islanders periodically to gain insights on their insurance status, health care costs, experience getting medical care, use of medical services, and relevant demographic variables. Six separate surveys have been conducted so far, with the first survey being administered in 2012. The most recent survey was administered via phone and online form to over nearly 2,900 households including 7,500 Rhode Islanders and delivered in English and Spanish. The margin of error on the topline result is plus 1.3% or minus 0.8%.

The full findings of the 2024 Rhode Island Health Information Survey are available at HealthSourceRI.com/Surveys-and-Reports