In 2018, more than 70,000 Cuyahoga County residents did not have health insurance coverage, making up 5.7 percent of the population. These results come from just-released data from the Census Bureau’s American Community Survey (ACS). The county’s uninsured rate was significantly lower than Ohio’s rate (6.5 percent) and the rate in the United States (8.9 percent). In the City of Cleveland, 30,000 people, or 7.9 percent of the population, were uninsured, a significantly higher rate than in Cuyahoga County and the state.

Uninsured rates differed by age. For working-age adults 19 to 64 in the county, 8.1 percent were uninsured, compared to 3.6 percent of children under 19 and 0.3 percent of seniors age 65 and older. In Cleveland, the same pattern held, but the rates were higher: 10.9 percent of working-age adults, 4.4 percent of children and 0.6 percent of seniors did not have health insurance. These differences are statistically significant.

Statewide, the uninsured rate increased significantly from 2017 to 2018 for adults ages 19 to 34 and those age 35 to 64.

These differences by age may be accounted for by differences in the source of insurance. Forty-three percent of children in the county rely on public coverage (Medicaid and SCHIP), and 97 percent of seniors receive Medicare benefits, although more than half also have private supplementary coverage. On the other hand, only about one-quarter of working-age adults in the county receive public coverage and only about two-thirds have private coverage, usually provided by their employer or union. Statewide, the uninsured rate increased significantly from 2017 to 2018 for adults ages 19 to 34 (from 10.3 to 11.4 percent) and those age 35 to 64 (6.8 to 7.4 percent).

In the City of Cleveland, 30,000 people … were uninsured, a significantly higher rate than in Cuyahoga County and the state.

Working-age adults with incomes under 138 percent of the federal poverty level provide an interesting sub-population to consider, as they are eligible for coverage under the Medicaid expansion. In Cuyahoga County 65.7 percent of this group (104,000 people) receive public coverage, as do 72.3 percent (63,000 people) in the City of Cleveland. Although these proportions are higher than Ohio’s rate of 62.3 percent, more outreach is needed to inform potential enrollees of their possible eligibility, and barriers to enrollment also need to be removed.