Private Insurance and Expanding Health Coverage

Most Americans rely on health insurance to help pay for their health care. And most who are younger than age 65 obtain coverage through the private insurance market. 

The majority of people age 50–64 have health insurance coverage through their employer. However, the share of people with such coverage has been declining. Before the 2010 Affordable Care Act (ACA), many adults age 50-64 had difficulty obtaining health care coverage if they did not receive it through an employer. The ACA has provided new opportunities to access health coverage through health insurance benefit exchanges known as marketplaces. It has also provided expanded coverage through Medicaid (see also this chapter’s section, Expanded Access to Health Care). 

Historically, the primary goals of health care reform efforts have been to ensure that everyone has access to affordable health care coverage and to provide adequate protection from health care costs. Reform efforts have included changes to the practices of private insurers. 

Many Americans continue to rely upon some form of private insurance even after they are eligible for Medicare. Some have private retiree health coverage through former employers that supplements Medicare. In addition, many beneficiaries in Traditional Medicare purchase private Medicare Supplement Insurance plans. Known as MedSupp or Medigap, it supplements their Medicare coverage.