July 30, 2013

The ACA’s Coverage Expansion in Michigan: Demographic Characteristics and Coverage Projections

Cover Michigan 2013

Introduction

In January 2014, the Affordable Care Act (ACA) will begin to offer new health insurance coverage options to millions of Americans, many of whom are currently uninsured. There is still considerable uncertainty, however, about how the coverage expansion will play out. Several states continue to debate whether to expand eligibility for their Medicaid programs as the ACA intended. Health insurance exchanges that will offer coverage in the individual and small group markets are still being developed by the federal government and many states for the open enrollment launch in October 2013. Employers, who still provide coverage to the majority of Americans, are evaluating what, if any, changes to make in their health care offerings.

All of these issues are reflected in activity in Michigan. To better understand the likely coverage effects of the ACA on Michigan’s insurance market, it is important to recognize the demographic characteristics of Michigan residents who will be most affected. This issue brief is intended to both describe the characteristics of these populations and project how the ACA will affect the overall picture of coverage in Michigan. Since there is still uncertainty about whether or not Michigan will move forward on an expansion of Medicaid, alternative projection scenarios are included.

Key findings include:

  • If Medicaid does expand in Michigan, it would have a large effect on young, childless adults. Forty percent of those who would be eligible for the expansion are between the ages of 19 and 24, and 77 percent do not have children.
  • Half of the adults (51 percent) who would be eligible for Medicaid under an expansion are employed, a much higher percentage than those currently enrolled in Medicaid.
  • Nearly three-fourths (71 percent) of those who would be eligible for subsidized coverage on the health insurance exchange are currently employed.
  • If Medicaid expands in Michigan, the uninsured rate in Michigan could be expected to drop to 6 percent by 2019. If not, the 2019 uninsured rate is expected to be 10 percent.
  • If Medicaid is expanded, by 2019, 93 percent of the uninsured will have an affordable coverage option (Medicaid or exchange-based tax credits). Without expansion, 40 percent of the uninsured will be left without an affordable coverage option.
  • Regardless of whether Medicaid eligibility is expanded, employers are still projected to provide coverage to a majority of Michigan residents in 2019.

Demographic Characteristics of ACA Target Populations

Following the U.S. Supreme Court’s June 2012 ruling in NFIB v. Sebelius, states will not face financial penalties if they do not expand Medicaid eligibility to non-elderly adults whose income is below 138 percent of the federal poverty level (FPL).1 Michigan and many states are still debating whether or not to proceed with Medicaid expansion for 2014. The ACA also expands insurance coverage by providing tax credit subsidies to many lower and middle income individuals and families to reduce the cost of private health insurance purchased through health insurance exchanges. Insurance exchanges (sometimes known as “marketplaces”) are mandatory under the ACA, but the eligibility thresholds for their tax credits depend on whether a state expands Medicaid.2 Exchanges will be implemented either by the federal government or by the states themselves directly or in partnership with the federal government. In Michigan in 2014, the health insurance exchange will be implemented by the federal government.

The two populations that are most affected by the ACA’s coverage expansion are:

  1. Non-elderly adults (aged 19–64) who will be eligible for Medicaid if a state approves the expansion; and
  2. Non-elderly adults (aged 19–64) who will be eligible for tax credits to subsidize private coverage purchased on the individual health insurance exchange.

Demographic characteristics of these populations are described below. Characteristics of children and the elderly in Michigan were not examined as their coverage eligibility will be largely unchanged by the ACA. Full data tables of demographic characteristics are available in the Appendix.

Current Form of Primary Coverage

In 2011, over 17 percent of Michigan’s adults aged 19 to 64 were uninsured. Those who would be eligible for one of the coverage provisions of the ACA were uninsured at much higher rates than the population at large. Specifically, more than half (55 percent) of those who would be eligible for Medicaid (if the state expands coverage) or for subsidies to purchase health insurance were uninsured. The remaining population (45 percent) of those eligible for coverage under the ACA had coverage through an employer, an individual policy, or another form of public insurance. Among those who would be eligible for Medicaid, half were uninsured in 2011 and 40 percent had employer-sponsored insurance. Figure 1 Those with private insurance would be eligible for Medicaid if eligibility is expanded and their income is below 138 percent FPL.

Figure 1
ACA Target Populations (Aged 19–64) by Primary Form of Coverage, 2011*

Figure 1

* Excluding those with employer-sponsored insurance (ESI) who may be subsidy eligible.

Source: CHRT Analysis of 2011 American Community Survey Data

1 Supreme Court of the United States. National Federation of Independent Businesses et al. v. Sebelius, Secretary of Health and Human Services, et al. June 2012. http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

2 If Medicaid eligibility is expanded, non-elderly adults will be eligible for tax credits if their income is between 138 percent and 400 percent FPL. If Medicaid eligibility is not expanded, tax credit eligibility extends to those between 100 percent and 400 percent FPL.

Age Distribution

The Medicaid expansion and exchange tax credits could have varied effects across age groups. The population who would be eligible for the Medicaid expansion is, on average, younger than people in the current Medicaid program. In 2011, 41 percent of the Medicaid expansion target population was between 19 and 24 years old. The average age of the Medicaid expansion population was 32.8 years, compared to 39.2 years for current Medicaid enrollees between ages 19 and 64.

The exchange tax credits will have a larger effect on older residents. Among the exchange target population in 2011, 46.5 percent were 45 to 64 years old, compared to 23.7 percent of the Medicaid expansion target population. Figure 2 If Medicaid is not expanded, the average age of the exchange-eligible population would decline slightly from 42.6 years to 41.3 years. This decline in the average age would be due to the addition of exchange eligible residents between 100 percent and 138 percent FPL, who were disproportionately younger.

Figure 2
ACA Target Populations (Aged 19–64) by Age, 2011

Figure 2

Source: CHRT Analysis of 2011 American Community Survey Data

Parent Status

Currently in Michigan, non-disabled childless adults are not eligible for full Medicaid benefits.3 Parents of dependent children are eligible for coverage if their income is below 64 percent FPL. Therefore, a Medicaid expansion would provide a new source of coverage not only to low-income childless adults but also to many low-income parents whose income is too high to qualify under current rules.

Among adults who would be eligible for Medicaid under expansion, 77 percent did not have children—a much higher rate than Medicaid enrollees (54 percent). Nearly two-thirds of the exchange target population was composed of childless adults. Figure 3

Figure 3
ACA Target Populations (Aged 19–64) by Parent Status, 2011

Figure 3

Source: CHRT Analysis of 2011 American Community Survey Data

3 Very low-income childless adults are eligible for limited coverage under the state’s Adult Benefit Waiver program.

Gender

Currently, Medicaid in Michigan provides coverage to pregnant women whose income is up to 185 percent FPL. Due to this and other caregiver eligibility categories a disproportionate share of current Medicaid enrollees are women. However, the ACA coverage expansion is likely to have a larger effect on Michigan’s male population. In 2011, men comprised a majority of both the Medicaid expansion and exchange eligible population, even though they are slight minority of non-elderly adults. Figure 4

Figure 4
ACA Target Populations (Aged 19–64) by Gender, 2011

Figure 4

Source: CHRT Analysis of 2011 American Community Survey Data

Employment Status

There is considerable variation in the employment status of the populations that will be affected by the ACA coverage provisions. The Medicaid expansion population is much more likely to be employed than current enrollees. In 2011, 51.2 percent of the total Medicaid expansion target population was employed Figure 5, with an effective employment rate of 72.3 percent (27.7 percent unemployment rate).4

Figure 5
ACA Target Populations (Aged 19–64) by Employment Status, 2011

Figure 5

Source: CHRT Analysis of 2011 American Community Survey Data

The exchange target population is even more likely to be employed than the Medicaid expansion target population. Among the total exchange population, 71.4 percent were employed, with an effective employment rate of 85.5 percent (14.5 percent unemployment rate). In 2011, the unemployment rate of non-elderly adults in Michigan was 12.5 percent.

4 The effective employment rate is the ratio of individuals employed to individuals participating in the labor force.

Educational Attainment

Along with having a higher income than the Medicaid expansion target population, the exchange target population has higher levels of educational attainment. Among those aged 25–64, 17.3 percent of the population that would be eligible for subsidized coverage on the exchange had a bachelor’s or higher degree in 2011, compared to 12.6 percent of the population who would be eligible for Medicaid. Figure 6 High school graduation rates also differ between these two populations, with 15.1 percent of the Medicaid expansion population having less than a high school degree, compared to 9.8 percent of the subsidy-eligible exchange population. Both groups, however, compare favorably to those currently enrolled in Medicaid in terms of education: 26 percent of current enrollees did not have a high school degree or equivalent and only 6.5 percent had a bachelor’s or higher degree in 2011.

Figure 6
ACA Target Populations (Aged 25–64) by Educational Attainment, 2011

Figure 6

Source: CHRT Analysis of 2011 American Community Survey Data

Race/Ethnicity

Racial and ethnic minorities comprise a disproportionate share of those currently enrolled in Medicaid. The minority composition of the Medicaid expansion and exchange target populations is closer to the distribution in the overall population. In Michigan, nonelderly African American adults in 2011 were overrepresented in the Medicaid expansion population (19.9 percent) and underrepresented in the exchange population (11.3 percent) relative to their representation in the overall non-elderly adult population (14.2 percent). However, other racial/ethnic minorities comprise a similar share of the Medicaid expansion and exchange target populations. Figure 7

Figure 7
ACA Target Populations (Aged 19–64) by Race/Ethnicity, 2011

Figure 7

Source: CHRT Analysis of 2011 American Community Survey Data

ACA Coverage Projection

The Affordable Care Act will have significant effects on the Michigan insurance market, especially if Medicaid eligibility is expanded. While some people in Michigan will still lack health insurance after the full implementation of the coverage provisions of the ACA, a very large number of those currently uninsured will gain coverage under the ACA. These effects are likely to increase over time as more people understand the coverage opportunities included in the ACA. While some decline in employer-sponsored insurance (ESI) is expected as some firms drop coverage and eligible individuals switch to the exchange or Medicaid, ESI is projected to still be the primary source of insurance coverage for the majority of non-elderly individuals.

Coverage Projections with Medicaid Expansion

If Michigan expands Medicaid, the number of nonelderly residents (aged 0–64) enrolled in Medicaid/ CHIP (Children’s Health Insurance Program) is expected to grow from 1.4 million (16.7 percent) in our 2011 baseline to just over 2 million (24.5 percent) by 2019. The number of uninsured residents is projected to drop from 1.1 million (13.6 percent) to just over 500,000 (6.3 percent) during the same period (see Figure 8). The majority of those still uninsured would most likely be people eligible for Medicaid or tax credits but not enrolled in either program.

Assuming that Medicaid expands, enrollment in the individual health insurance exchange is projected to be relatively modest in 2014 with 127,000 enrollees, growing to over 550,000 by 2019. It is important to note that the projections shown below do not look separately at the number of employees enrolled in the Small Business Health Options (SHOP) exchange through their employer. Those individuals are included in employer-sponsored coverage figures below since they are still getting coverage from their employer; they would just be getting that coverage through a different mechanism than they do today. Figure 8

Figure 8
Projected Health Insurance Coverage for Non-Elderly Residents (Aged 0–64) with Medicaid Expansion

Figure 8
  2011 2014 2019
Uninsured 1,147,613 13.6% 864,300 10.3% 528,001 6.3%
Employer 5,090,087 60.5% 5,010,780 59.6% 4,764,218 56.6%
Medicaid/CHIP 1,402,191 16.7% 1,729,693 20.6% 2,061,715 24.5%
Nongroup & Other Public 772,844 9.2% 681,133 8.1% 504,984 6.0%
Exchange   NA 126,828 1.5% 553,816 6.6%
Total 8,412,735 100.0% 8,412,735 100.0% 8,412,735 100.0%

Source: CHRT Analysis of 2011 American Community Survey Data

Coverage Projections without Medicaid Expansion

If Medicaid does not expand in Michigan, the reduction in the number of uninsured would be much more modest, with nearly 830,000 individuals (9.8 percent) of non-elderly residents (aged 0–64) projected to remain uninsured in 2019. Figure 9 Since exchange tax credits would be available to those whose income is between 100 and 138 percent of the federal poverty level, a larger number of Michigan residents would likely purchase private coverage through the insurance exchange than they would if Michigan expands Medicaid. This difference is expected to be very modest in 2014 but will likely grow over time. Specifically, by 2019 we estimate that exchange enrollment will include nearly 120,000 more individuals if Medicaid is not expanded.

Even without Medicaid expansion, Medicaid enrollment is still projected to grow somewhat (see Figure 9). This is due to the Medicaid simplification and streamlining requirements in the ACA, which will likely make it easier for those eligible under current program requirements to enroll. Figure 9

Figure 9
Projected Health Insurance Coverage for Non-Elderly Residents (Aged 0–64) without Medicaid Expansion

Figure 9
  2011 2014 2019
Uninsured 1,147,613 13.6% 1,031,176 12.3% 827,753 9.8%
Employer 5,090,087 60.5% 5,083,280 60.4% 4,938,450 58.7%
Medicaid/CHIP 1,402,191 16.7% 1,440,635 17.1% 1,462,484 17.4%
Nongroup & Other Public 772,844 9.2% 697,060 8.3% 512,347 6.1%
Exchange   NA 160,584 1.9% 671,701 8.0%
Total 8,412,735 100% 8,412,735 100% 8,412,735 100%

Source: CHRT Analysis of 2011 American Community Survey Data

Projections for the Uninsured in 2019

The Medicaid expansion has large consequences for the coverage options available to uninsured residents in Michigan. If the expansion occurs, 53 percent of the uninsured are projected to gain insurance by 2019, with the majority enrolling in Medicaid. If Medicaid is not expanded, only 27 percent of the uninsured are expected to enroll in a health plan.

If Medicaid eligibility is expanded, 93 percent of the uninsured will have access to one of the ACA’s coverage provisions (Medicaid or exchange tax credits), regardless of whether they actually enroll. Figure 10 Those who would not be eligible for one of these provisions include persons who would not qualify for a tax credit because their income is more than 400 percent FPL, unauthorized immigrants, and non-citizens ineligible for Medicaid because they have less than five years of U.S. residency.5 If Medicaid eligibility is not expanded, only 60 percent of the uninsured population is expected to have access to an ACA coverage provision due to the fact that exchange tax credits are not available to individuals below 100 percent FPL. Specifically, the ACA makes exchange tax credits available to qualified individuals between 100 percent and 400 percent FPL, unless they are eligible for Medicaid.

Figure 10
Projected Health Insurance Coverage for Non-Elderly Uninsured Residents (Aged 0–64) by 2019

Figure 10
Coverage Projections for the Uninsured, 2019 With Medicaid Expansion Without Medicaid Expansion
Gain Insurance Coverage 612,461 53.4% 306,758 26.7%
Enrolled in Medicaid 428,885 37.4% 46,091 4.0%
Enrolled in Exchange 183,576 16.0% 260,667 22.7%
Remain Uninsured 535,152 46.6% 840,855 73.3%
Uninsured, Medicaid Eligible 262,887 22.9% 117,315 10.2%
Uninsured, Exchange Eligible 188,563 16.4% 264,799 23.1%
Uninsured, neither Medicaid nor Exchange Eligible 83,701 7.3% 458,742 40.0%
Total 1,147,613 100.0% 1,147,613 100.0%

5 Citizens and legally present non-citizens whose income is more than 400 percent FPL can still enroll in a health plan through the exchange without premium tax credits.

Methodology

American Community Survey (ACS) data was obtained from the Integrated Public Use Microdata Series (IPUMS-USA) at the Minnesota Population Center, University of Minnesota.6 Analysis was conducted for the non-institutionalized civilian population in 2011. Since 2008, the ACS has included questions about what forms of health insurance household members have. Since individuals may have multiple forms of coverage, they are assigned to a category of coverage based on the likely primary payer for acute care services. Compared to other briefs in CHRT’s Cover Michigan series, this brief uses different data methods, so similar figures in this brief may not perfectly match those in the others.

This analysis used health insurance units (HIUs) for calculating income for the purposes of determining ACA program eligibility. The HIU definition was developed by the State Health Access Data Assistance Center (SHADAC) at the University of Minnesota.7 HIUs differ from the Census Bureau’s definitions of household and family by grouping together only people who are considered a “family unit” for the purposes of public or private insurance coverage. Unrelated people and certain types of relatives (such as grandparents) typically form their own HIU, separate from related parents and children.

Coverage projections were not calculated directly from a microsimulation model, nor did they account for future macroeconomic trends. Rather, take-up rates for Medicaid and health insurance exchange coverage were developed from a set of publicly available resources and applied to eligible populations. Medicaid take-up rates came from the Urban Institute’s June 2012 report on the ACA Medicaid Expansion in Washington State.8 Exchange take-up rates for 2019 came from the California Simulation of Insurance Markets.9 Incremental changes to exchange take-up rates were calculated from the Congressional Budget Office’s February 2013 report of the effects of the ACA on insurance coverage.10 Effective take-up rates used in this analysis are available by request.

6 Steven Ruggles, J. Trent Alexander, Katie Genadek, Ronald Goeken, Matthew B. Schroeder, and Matthew Sobek. Integrated Public Use Microdata Series: Version 5.0 [Machine-readable database] (Minneapolis, Min.: University of Minnesota, 2010). https://usa.ipums.org/usa/ (accessed 6/29/13).

7 State Health Access Data Assistance Center. 2012. Defining “Family” for Studies of Health Insurance Coverage, Issue Brief 27 (Minneapolis, Min.: University of Minnesota). http://www.shadac.org/publications/defining-family-studies-health-insurance-coverage (accessed 6/29/13).

8 Matthew Buettgens, Randall R. Bovbjerg, Caitlin Carroll, and Habib Moody. May 2012. The ACA Medicaid Expansion in Washington (Washington, D.C.: Urban Institute). http://www.urban.org/health_policy/url.cfm?ID=412581 (accessed 6/29/13).

9 Gerald F. Kominski, Ken Jacobs, Dylan H. Roby, Dave Graham-Squire, Christina M. Kinane, Greg Watson, Daphna Gans, and Jack Needleman. June 2012. California Simulation of Insurance Markets (CalSIM) Version 1.7: Health Insurance Coverage in California under the Affordable Care Act, Revision of the March 22, 2012 Presentation to the California Health Benefit Exchange Board (Berkeley and Los Angeles, Cal.: UC Berkeley Labor Center and UCLA Center for Health Policy Research. http://laborcenter.berkeley.edu/healthcare/aca_chartpack.pdf (accessed 6/29/13).

10 Congressional Budget Office. N.d. CBO’s February 2013 Estimate of the Effects of the Affordable Care Act on Health Insurance Coverage, CBO’s February 2013 Estimate of the Budgetary Effects of the Insurance Coverage Provisions Contained in the Affordable Care Act, and Health Insurance Exchanges: CBO’s February 2013 Baseline. http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900_ACAInsuranceCoverageEffects.pdf (accessed 6/29/13).

Definitions

Medicaid Enrolled
Non-elderly adults (aged 19–64) who were enrolled in Medicaid in 2011 under a pre-ACA eligibility category.
Medicaid Eligible under Expansion
Non-elderly (aged 19–64) adults who had no insurance, individual insurance, employer-sponsored insurance (ESI), or other public coverage11 in 2011 and whose income was below 138 percent of the federal poverty level (FPL). This includes both adults who would be newly eligible and those are that are eligible under current rules. Non-citizens with less than five years of U.S. residency were excluded.12
Exchange Eligible with Medicaid Expansion
Nonelderly adults (aged 19–64) who had no insurance, individual insurance, or other public coverage and whose income was between 138 percent FPL and 400 percent FPL. Adults with ESI were not included.13
Exchange Eligible without Medicaid Expansion
Non-elderly adults (aged 19–64) who had no insurance, individual insurance, or other public coverage and whose income was between 100 percent FPL and 400 percent FPL. Adults with ESI were not included.

11 Other public insurance includes coverage under the Veterans Health Administration, TRICARE, or the Indian Health Service.

12 In addition, unauthorized immigrants would also be excluded from Medicaid and exchange-based coverage. However, the ACS, on its own, does not have adequate data to determine legal status, so legal status was not evaluated in this analysis.

13 People between 100 percent or 138 percent FPL and 400 percent FPL (depending on Medicaid expansion) who currently have ESI may be eligible for exchange tax credits. However, they are only eligible if their ESI offer is unaffordable or does not meet minimum value requirements. Since the quality of ESI offers cannot be determined using Census data, we do not examine the characteristics of the ESI population in this income range.

Appendix

All tables below were calculated from the 2011 American Community Survey (ACS).

Current Form of Primary Coverage

Primary Coverage Medicaid Enrolled Medicaid Eligible under Expansion Exchange Eligible if Medicaid Expands Exchange Eligible if Medicaid does not Expand Michigan Population
(19–64 years)
# % # % # % # % # %
Uninsured 0 0.0% 628,557 49.9% 336,778 68.4% 483,069 72.3% 1,046,844 17.5%
Employer-Sponsored 67,880 8.4% 509,465 40.5% 0 0.0% 0 0.0% 3,698,306 61.9%
Medicaid 585,591 72.2% 0 0.0% 0 0.0% 0 0.0% 585,591 9.8%
Nongroup & Other Public 158,075 19.5% 120,629 9.6% 155,764 31.6% 185,184 27.7% 647,954 10.8%
Total 811,546 100% 1,258,651 100% 492,542 100% 668,253 100% 5,978,695 100%

Age Distribution

Age Medicaid Enrolled Medicaid Eligible under Expansion Exchange Eligible if Medicaid Expands Exchange Eligible if Medicaid does not Expand Michigan Population
(19–64 years)
# % # % # % # % # %
19–24 years 136,322 16.8% 521,872 41.5% 36,314 7.4% 72,920 10.9% 828,136 13.9%
25–34 years 198,501 24.5% 269,222 21.4% 119,809 24.3% 163,984 24.5% 1,150,802 19.2%
35–44 years 176,269 21.7% 169,488 13.5% 107,236 21.8% 143,926 21.5% 1,237,353 20.7%
45–54 years 165,381 20.4% 177,724 14.1% 120,280 24.4% 154,471 23.1% 1,467,388 24.5%
55–64 years 135,073 16.6% 120,345 9.6% 108,903 22.1% 132,952 19.9% 1,295,016 21.7%
Total 811,546 100% 1,258,651 100% 492,542 100% 668,253 100% 5,978,695 100%

Parent Status

Parent Status Medicaid Enrolled Medicaid Eligible under Expansion Exchange Eligible if Medicaid Expands Exchange Eligible if Medicaid does not Expand Michigan Population
(19–64 years)
# % # % # % # % # %
Adult with Children 375,863 46.3% 287,319 22.8% 179,712 36.5% 242,253 36.3% 2,446,657 40.9%
Adult without Children 435,683 53.7% 971,332 77.2% 312,830 63.5% 426,000 63.7% 3,532,038 59.1%
Total 811,546 100% 1,258,651 100% 492,542 100% 668,253 100% 5,978,695 100%

Gender

Gender Medicaid Enrolled Medicaid Eligible under Expansion Exchange Eligible if Medicaid Expands Exchange Eligible if Medicaid does not Expand Michigan Population
(19–64 years)
# % # % # % # % # %
Male 334,292 41.2% 658,007 52.3% 255,681 51.9% 344,848 51.6% 2,933,193 49.1%
Female 477,254 58.8% 600,644 47.7% 236,861 48.1% 323,405 48.4% 3,045,502 50.9%
Total 811,546 100% 1,258,651 100% 492,542 100% 668,253 100% 5,978,695 100%

Employment Status

Employment Status Medicaid Enrolled Medicaid Eligible under Expansion Exchange Eligible if Medicaid Expands Exchange Eligible if Medicaid does not Expand Michigan Population
(19–64 years)
# % # % # % # % # %
Employed 235,595 29.0% 644,138 51.2% 351,528 71.4% 470,594 70.4% 3,938,326 65.9%
Unemployed 138,431 17.1% 246,670 19.6% 59,372 12.1% 88,147 13.2% 559,099 9.4%
Not in labor force 437,520 53.9% 367,843 29.2% 81,642 16.6% 109,512 16.4% 1,481,270 24.8%
Total 811,546 100% 1,258,651 100% 492,542 100% 668,253 100% 5,978,695 100%

Educational Attainment

Educational Attainment (25–64) Medicaid Enrolled Medicaid Eligible under Expansion Exchange Eligible if Medicaid Expands Exchange Eligible if Medicaid does not Expand Michigan Population
(19–64 years)
# % # % # % # % # %
Less than High School 175,533 26.0% 111,266 15.1% 44,727 9.8% 66,356 11.1% 460,097 8.9%
High School or equivalent 244,222 36.2% 264,610 35.9% 164,311 36.0% 216,027 36.3% 1,473,876 28.6%
Some College or Associate’s degree 211,485 31.3% 268,003 36.4% 168,461 36.9% 218,810 36.8% 1,791,261 34.8%
Bachelor’s or higher degree 43,984 6.5% 92,900 12.6% 78,729 17.3% 94,140 15.8% 1,425,325 27.7%
Total 675,224 100% 736,779 100% 456,228 100% 595,333 100% 5,150,559 100%

Race/Ethnicity

Race/Ethnicity Medicaid Enrolled Medicaid Eligible under Expansion Exchange Eligible if Medicaid Expands Exchange Eligible if Medicaid does not Expand Michigan Population
(19–64 years)
# % # % # % # % # %
White, Non-Hispanic 499,872 61.6% 906,594 72.0% 394,098 80.0% 524,285 78.5% 4,682,357 78.3%
Black, Non-Hispanic 248,896 30.7% 250,467 19.9% 55,414 11.3% 81,705 12.2% 849,600 14.2%
Hispanic 45,438 5.6% 67,959 5.4% 27,012 5.5% 40,918 6.1% 247,405 4.1%
Other 17,340 2.1% 33,631 2.7% 16,018 3.3% 21,345 3.2% 199,333 3.3%
Total 811,546 100% 1,258,651 100% 492,542 100% 668,253 100% 5,978,695 100%

Suggested Citation: Fangmeier, Joshua; Udow-Phillips, Marianne. The ACA’s Coverage Expansion in Michigan: Demographic Characteristics and Coverage Projections. Cover Michigan 2013. July 2013. Center for Healthcare Research & Transformation. Ann Arbor, MI.