The percentage of people in Nassau County without health insurance...

The percentage of people in Nassau County without health insurance fell from 4.8% in 2017 to 3.9% in 2018, and in Suffolk, from 4.5% to 3.9%, census data shows. Credit: Kevin P. Coughlin

The percentage of Long Islanders without health insurance dropped below 4% in 2018, continuing a steady yearslong decline in the rate of the uninsured, as nationally that number rose in 2018 for the first time since the Affordable Care Act went into effect.

The proportion of people in Nassau County without health insurance fell from 4.8% in 2017 to 3.9% in 2018, and in Suffolk County it dropped from 4.5% to 3.9%, according to U.S. Census Bureau estimates released early Thursday.

The census data also showed that the median household income on Long Island was up and commute times were longer.

In 2010, when the Affordable Care Act — also known as Obamacare — was enacted, the uninsured rate in both counties was above 10%. The law went into full effect in 2014. The percentage of people statewide without health insurance also has declined sharply since 2010.

Nationally, the percentage of Americans without health care coverage rose from 7.9% in 2017 to 8.5% in 2018, according to census data released earlier this month.

Efforts nationally “to make it challenging” for people to enroll in Affordable Care Act coverage and the Trump administration’s rhetoric assailing the law contrast with New York State’s promotion of it, a key reason New Yorkers are more likely to have health insurance than other Americans, said Rebecca Sanin, president and CEO of the Health and Welfare Council of Long Island.

“New York State, having its [health insurance] marketplace, has always worked hard to protect New Yorkers’ access to health care,” she said. “So there’s a public messaging about the fact we want people to be insured in New York State that has been intentional and consistent.”

The Trump administration cut funding to promote the Affordable Care Act and help people with the enrollment process.

New York State has its own health insurance marketplace. Many states use a federal insurance exchange, and the impact of reduced promotion of the law likely is greatest in those states, said Dr. Norman Edelman, a professor at the Renaissance School of Medicine at Stony Brook University and an expert in public health.

Part of the reason for the rise in the number of uninsured people nationally is a drop in the number of people on Medicaid, census data shows. Edelman said that may partly be because, with unemployment low, more people have employer-based coverage.

Brian Blase, a former special assistant for health care policy in the Trump administration, told The New York Times that the drop in Medicaid coverage also may be because some people who enrolled in the program after the law went into effect weren’t eligible and “my sense is in 2018 states probably started tightening eligibility.”

Sanin said the Trump administration’s immigration rhetoric also had an effect. Many people who are U.S. citizens have family members living in the country illegally, and those citizens are worried about scrutiny of their family members and are less likely to enroll or stay in government programs, she said.

The census data also showed that the median household income for Long Islanders rose by several thousand dollars between 2017 and 2018, and by more than 9% since 2014, using 2018 inflation-adjusted dollars.

In Nassau County, the median household income rose from $110,892 in 2017 to $116,304 in 2018. In Suffolk, it increased from $97,046 to $100,468.

That is reflective of “a very strong economy and more people working than ever before,” said Kevin Law, president and CEO of the Long Island Association, the region’s largest business group.

Nassau County median incomes long have been higher than Suffolk’s in large part because “over 30% of Nassau residents still work in New York City, and New York City wages are higher, predominantly, than Long Island wages,” he said.

The large amount of Nassau residents working in the five boroughs also explains why the median commute time is longer for Nassau than Suffolk residents: 37.4 minutes for Nassau residents and 33.3 minutes for Suffolk residents, Law said.

The census data revealed that commute times on Long Island continue to grow. They’re up by more than three minutes compared with 2010.

Law said that’s because with “more people working, more people are on the roads.”

“I remember in 2008 and 2009 and 2010 when I was commuting from St. James to Uniondale, the traffic wasn’t that bad,” he said. “And a big reason for that was the higher unemployment rate.”


The percent of people without health insurance in New York and Long Island fell significantly between 2010 and 2018.

New York State, 2010: 11.9%

New York State, 2018: 5.4%

Nassau County, 2010: 10.2%

Nassau County, 2018: 3.9%

Suffolk County, 2010: 10.4%

Suffolk County, 2018: 3.9%


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