Across Southeastern Michigan all seven counties experienced an increase in the percentage of residents with health insurance between 2010 and 2015. In 2010 then President Barack Obama signed the Affordable Care Act into law; this is a piece of legislation that was crafted to increase access to and the quality of health insurance. Wayne County experienced the largest increase in overall health insurance coverage at 2.8 percent. In 2015, according the American Community Survey, 87.7 percent of the Wayne County population had health insurance. Wayne County also experienced the largest increase in private health insurance regionally at 17.5 percent. Of those with health insurance coverage in Wayne County in 2015, 83.2 percent had private health insurance coverage. For areas like Wayne County, where the percentage of those on private insurance plans has increased, it is likely due to the larger amount of private insurance options the Affordable Health Care Act offers.

On the opposite end of the spectrum, Livingston County experienced the smallest percentage increase in overall health insurance coverage between 2010 and 2015 at 1.4 percent; 93.3 percent of the residents there had coverage in 2015. While Livingston County also had the lowest increase in private health insurance coverage regionally in that time frame, it experienced the largest increase in public health insurance coverage at 28.2 percent.  In 2015, 24.4 percent of those with health insurance coverage in Livingston County had public health insurance coverage; this translates to about 44,800 residents. Majority of those in Livingston County between the ages of 18 and 64 in 2015 with public coverage were not in the labor force (56%); 36 percent of that population was in the labor force and 8 percent was unemployed.

When examining the child population regionally, there was no increase in the percentage of children uninsured in Livingston County. Washtenaw County experienced the largest decrease at 30.6 percent. In 2015 2.5 percent of Washtenaw County’s child population was uninsured; this was equivalent to about 1,700 children. Wayne County, which hosts the city with the largest percentage of uninsured children regionally (Hamtramck) experienced about a 25 percent decrease in the percentage of uninsured children. In 2015 in Wayne County about 16,700 children, or 4 percent of the County’s child population, was without health insurance.

In examining this data we see that since the enactment of the Affordable Care Act thousands of residents throughout Southeastern Michigan have been granted more access to health care. According to a New York Times article, those who benefited the most from the Affordable Care Act were those between the ages of 18-34, those living in rural areas and those who are black and Hispanic. In Wayne County, which had the biggest overall percentage increase in insured residents about 25 percent of the population in 2015 was between the ages of 18-34 and about 40 percent of the population was black and about 6 percent of the population was Hispanic. It was also noted in the article that those with lower incomes tended to benefit more from the Affordable Care Act.

In Michigan, majority of residents have a form of health care coverage, but the kind of coverage often varies. In Southeastern Michigan, the majority of the region has some type of private health care coverage, but there are several municipalities where majority of the residents depend upon public coverage. According to the Michigan Department of Health and Human Services there are several publicly funded medical assistance programs offered to residents, depending on their age, income, financial resources and other requirements. Public health insurance programs in Michigan include Medicaid, Healthy Michigan Plan and the Children’s Health Insurance Program.

For this post the percentage of residents covered by health insurance is examined, as is the percentage of residents with private or public insurance plans.

Throughout Southeastern Michigan health care coverage for residents ranges from 78 to 100 percent, with only about 15 municipalities having 96 percent or more of its residents having coverage, according to the American Community Survey conducted by the Census. Of these 15 municipalities, most are located in Oakland and Washtenaw counties. Overall, in Oakland County 92 percent of residents had health insurance coverage in 2015, and in Washtenaw County 94 percent of the population had coverage. In Oakland County Bloomfield Hills and Lake Angelus had the highest percentage of coverage at 99 percent, and in Washtenaw County, Dexter had the highest rate of coverage at 97 percent. At the opposite end Hamtramck had the lowest percentage of residents with coverage—77 percent. Put differently, 23 percent had no coverage. In Detroit about 17 percent of the population had no health insurance coverage in 2015.

Regionally, Livingston and Washtenaw counties had the highest percentages of residents on private health insurance at 83 and 82 percent. In Washtenaw County more than half of the municipalities had above 85 percent of its residents on private health insurance. In Wayne County, 58 percent of the residents had private health insurance and only a handful of communities (Grosse Ile, Northville Township and the Grosse Pointes) had more than 85 percent of its residents on private health insurance. On the opposite side of the spectrum, there were five communities in Wayne County where 50 percent or less of the population had private health insurance.

The map below somewhat mirrors the map above, showing the percentage of residents with public health insurance, as opposed to private. With cities like Detroit, Highland Park and Hamtramck having some of the lowest percentages of private health insurance, it should only make sense that they had among the highest percentages of residents with public health insurance. Highland Park had the highest percentage of residents on public health insurance at 62 percent; Ecorse followed with 60 percent of its residents on public health insurance. Detroit and Hamtramck each had 55 percent of their residents on public health insurance.

Clearly there is a major divide running through Southeastern Michigan on who gets health insurance and where it comes from. Generally higher income communities have more coverage and a higher proportion comes from the private sector. Lower income communities depend heavily on various public sector programs, and many residents still do not have health care coverage. Clearly these lower income citizens and communities would be severely harmed by proposals to cut public health care programs.