Data Shows Most Significant Increase In Uninsured In Almost A Decade – Right Before Pandemic Hit


“History has shown us that those who bear the brunt of poverty inequities—people of color, non-citizens, women-headed households—are also hit the hardest when recessions come. Similarly, those with least access to healthcare, even in the good times, are at highest risk during health emergencies.”

Data released today from the U.S. Census Bureau revealed that health insurance coverage rates declined in Illinois and throughout the nation in 2019, continuing a disturbing trend of eroding the gains of the Affordable Care Act (ACA), right before a global pandemic and economic recession hit.

Nationwide, the number of uninsured people climbed by one million people from 28.6 million (8.9%) in 2018 to 29.6 million people (9.2%) in 2019. Illinois’s overall uninsured rate (7.4%) grew for the second time in the past three years, and uninsured rates for non-seniors went up from 8.1% in 2018 to 8.6% in 2019—the third year in a row. Illinois saw a decline in Medicaid coverage for over 121,000 non-seniors from 2018 to 2019, a drop of 0.8 percentage points. The majority of the people who lost Medicaid were in the Chicago six county area.

Conditions are likely to have worsened amid the coronavirus pandemic. In 2020, it is estimated 846,000 Illinoisans lost employer-sponsored insurance due to job loss during the pandemic,[1] and Illinois has experienced more modest increases in Medicaid enrollment during the pandemic than the rest of the nation.[2]

“History has shown us that those who bear the brunt of poverty inequities—people of color, non-citizens, women-headed households—are also hit the hardest when recessions come. Similarly, those with least access to healthcare, even in the good times, are at highest risk during health emergencies,” said Katie Buitrago, director of research at Heartland Alliance. “We currently face both a pandemic and a recession. This data shows us that millions were already living on the edge heading into 2020; the federal government must act immediately to ensure that they don’t fall off entirely.”

In 2019, Trump administration officials continued to neglect and sow confusion within the ACA health insurance marketplace, and pursue extreme and punitive immigration policies that discouraged enrollment in health insurance. Court battles likely confused people about the status of the ACA and depressed enrollment. And ongoing battles related to the public charge immigration rule only worsened the situation.

“The continued erosion of health insurance coverage in 2019 was not surprising,” said Dan Rabbitt, senior health policy manager for Heartland Alliance. “The Trump administration has undermined the ACA at every turn and has discouraged immigrant communities from accessing the public benefits they are entitled to. This resulted in some families not being covered by health insurance right before the COVID pandemic hit—and many more families losing insurance due to unemployment in 2020. Every person deserves to have access to health care, especially during the worst public health crisis of our lifetimes.”

In addition to this nationwide decline in the number of uninsured, the new data found that the official poverty rate in the United States declined to 10.5 percent, a 1.3 percentage point drop from 2018, and Illinois’s rate dropped to 11.5 percent. This year marks the lowest poverty rates observed nationwide since estimates were published in 1959. This is also the first year that poverty rates in Illinois were below pre-2008 recession levels, meaning that the state’s poverty rates took 11 years to recover from the previous recession. However, we can’t lose sight of the fact that a staggering 34 million Americans and 1.4 million Illinoisans were living in poverty and still struggling every day to meet their most basic needs, even before the pandemic. In addition, the national data on poverty was collected amidst the pandemic, resulting in much lower response rates that could understate the true extent of poverty.

It is important to note that these data reflect conditions in 2019—the last year of an economic expansion, before the pandemic-related recession hit. A historic global pandemic and the ensuing economic crisis in 2020 will tell a much different story than the one we see from 2019. Indeed, initial data from smaller but more recent Census surveys already paint a more troubling picture.[3] Nationwide, 45.3% of adults report living in a household where someone has lost income from work since mid-March 2020 (that figure is 43.1% for Illinois). And 56.2% of Latinos in the U.S. (54.8% in Illinois), and 52.2% of Black people (54.4% in Illinois), have lost household income since mid-March 2020. As we look forward to and plan for eventual recovery, 2019 data will be the new benchmark for getting back to where we were.

Heartland Alliance Poverty Experts Available for Commentary

Additional findings from the release revealed:


  • Over 630,000 Illinoisans are living in extreme poverty—meaning a family of three is living on less than about $10,168 per year. It is estimated that a family of three in Illinois needs about $65,000 a year to make ends meet.
  • There are 4 million people experiencing poverty in Illinois. Poverty rates are 1.8 to 3.1 times higher for Illinoisans of color.
  • Illinois median household income increased from 2018 to 2019, and in 2019 was $69,187. This is the first year that median household income exceeded 2007, before the previous recession (2% or $1,380 higher than 2007).
  • Black households were the only major racial/ethnic group in Illinois who did NOT experience an increase in household income from 2018 to 2019. Household income increased for Asian households (9.4%), White households (3.5%), and Latino households (6.1%) from 2018 to 2019.
  • Poverty rates for children, female-headed households, and communities of color remain dramatically higher than the overall rate. 39 percent of Illinoisans in poverty work, and 31 percent of Illinoisans in poverty are children. Over half (51 percent) of Illinoisans in poverty are Black or Latino.
  • 23% of Illinois renter households pay more than half of their income in rent.

Read the fact sheet on Illinois and Chicago region poverty, income, and health insurance trends based on the newly released data. https://socialimpactresearchcenter.issuelab.org/resource/poverty-income-health-insurance-update-illinois-and-chicago-region.html

Access interactive local data for Chicago Community Areas, all cities and townships in the six-county Chicago metropolitan region, and all counties in Illinois. https://www.heartlandalliance.org/data-dashboards/

Access the Census Bureau’s local demographic, social, economic, and housing data that were released today for places with populations of 65,000 or more. Contact Heartland Alliance for assistance accessing and interpreting the data. http://data.census.gov/

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Heartland Alliance, one of the world’s leading anti-poverty and human rights organizations, works in communities in the U.S. and abroad to serve people experiencing homelessness, living in poverty, or seeking safety. The organization provides a comprehensive array of services and advocates for policy change in the areas of safe and justice, health and healing, and economic opportunity. For more information visit, http://www.heartlandalliance.org

Heartland Alliance Research & Policy – Heartland Alliance’s Research & Policy Division focuses on the realization of human rights through ending poverty, racism, and injustice by engaging in research on social issues and solutions, policy and systems change, and field building nationwide. Learn more on the Research & Policy webpage: https://www.heartlandalliance.org/program/research-and-policy/.

1 https://www.kff.org/report-section/eligibility-for-aca-health-coverage-following-job-loss-appendix/

2 https://www.cbpp.org/blog/medicaid-enrollment-continues-to-rise

3 Table 1: https://www.census.gov/data/tables/2020/demo/hhp/hhp13.html

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