US Health Insurance Trends: 2024-2034 – Healthcare Economist





The Congressional Budget Office (CBO) recently provided projections of U.S. health insurance levels between 2024 and 2034. In the Hale et al. (2024) study, CBO estimates that:

…92.3 percent of the U.S. population, or 316 million people, will have coverage in 2024, and 7.7 percent, or 26 million, will be uninsured. The share of the population without insurance will increase over the course of the next decade, before leveling off at 8.9 percent in 2034, largely as a result of the end of Medicaid policies related to the COVID-19 pandemic. the expiration of enhanced subsidies available through the Affordable Health Fund. Care Act, health insurance markets, and a surge in immigration beginning in 2022. The largest increase in the uninsured population will occur among adults ages 19-44. Employment-based coverage will be the predominant source of health insurance, and as the population ages, Medicare enrollment will grow significantly. Following higher-than-expected enrollment in 2023, Marketplace enrollment is projected to reach an all-time high of twenty-three million people in 2025.

https://www.healthaffairs.org/doi/10.1377/hlthaff.2024.00460

The CBO estimates that Medicare enrollment (in Parts A and B) will increase from 61 million in 2024 to 74 million in 2034. This is not surprising with an aging population. Perhaps most surprising, the CBO projects that Medicare Advantage enrollment will increase from just over half of beneficiaries in 2024 to nearly two-thirds of beneficiaries in 2034.

CBO estimates for health insurance levels for the noninstitutionalized civilian population under age 65 are based on CBO’s Health Insurance Simulation Model (HISIM2), a structural expected utility model. The details behind the HISIM2 model are explained in Hanson et al. (2023).

You can read the complete study here, and the full reference projections here.



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