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Americans with health coverage up

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The percentage of Americans without health insurance continues to fall, dropping for the first time to below 10% in 2015, according to the National Center for Health Statistics.

The uninsured rate tumbled to 9.1% last year, down from 11.5% in 2014 and a steep decline from 16% in 2010, the NCHS reported Tuesday.

In all, 28.6 million people were uninsured in 2015 compared to 36 million in 2014, according to the NCHS report.

Key reasons for the big drop in the percentage of uninsured include provisions in the 2010 health care reform law, which took effect in 2014, that give federal premium subsidies to the lower-income uninsured to purchase coverage in ACA exchanges and gave states authority — with heavy federal financial support — to expand their Medicaid programs. The individual subsidies cover those earning between 100% and 400% of the federal poverty level; for example, premium subsidies are available in 2016 for a family of four collectively earning up to $97,200.

For example, enrollment in ACA exchanges hit 9.1 million during the last quarter of 2015, up from 6.7 million a year earlier.

In addition, the uninsured rate in states that expanded their Medicaid programs fell to 9.8% in 2015, down sharply from 18.4% in 2013.

Uninsured rates, though, varied considerably by state. For example, just 2.2% of Massachusetts' residents were uninsured last year — the lowest of any state, while Texas had the highest uninsured rate: 16.8%.

The survey also found that 36.7% of those under age 65 with private health insurance coverage were enrolled in high-deductible plans, defined as those with deductibles of at least $1,300 for single coverage and $2,600 for family coverage. Private health insurance coverage includes both employment-based coverage and individual policies.

Of that 36.7%, 13.3% were in CDHPs, which are high-deductible plans, linked to health savings accounts, while 23.4% were enrolled in high-deductible plans not linked to HSAs.