An Overview of 2024 Coverage for Veterans Beyond Veterans Affairs

Although US veterans have many coverage options, including Veterans Affairs (VA), Medicaid, and the Affordable Care Act (ACA) marketplace, many are projected to remain uninsured in 2024, according to a brief from the Robert Wood Johnson Foundation (RWJF).

The researchers pulled data from the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM) and the 2021 American Community Survey.

While veterans are less likely to be uninsured than nonveterans, a substantial portion of the population lacks coverage. In 2024, experts expect around 5 percent of veterans to be uninsured.

The primary sources of coverage for veterans in all states in 2024 will be employer-sponsored health plans (56.9 percent), public payer coverage including the VA (22.0 percent), and Medicaid (9.4 percent). Veterans are also less likely to have subsidized or unsubsidized nongroup health insurance than nonveterans.

In Medicaid expansion states, veterans are much more likely to have Medicaid coverage (11.0 percent) than veterans in nonexpansion states (5.9 percent) and veteran uninsurance is 5.9 percentage points lower in expansion states than nonexpansion states. In nonexpansion states, a higher share of veterans has subsidized nongroup health insurance coverage or other public payer coverage including Veterans Affairs.

In 2024, 47.5 percent of veterans who are uninsured will be eligible for either Medicaid or subsidized ACA marketplace coverage.

A quarter of uninsured veterans will be eligible for but not enrolled in Medicaid. Additionally, 22.4 percent of uninsured veterans will be eligible for subsidized coverage on the ACA marketplace. And a little over one in ten uninsured veterans would qualify for Medicaid under Medicaid expansion but they live in nonexpansion states.

Veterans with disabilities were least likely to be uninsured. Only 1.1 percent of veterans with service-related disabilities were uninsured. This is because service-related disabilities automatically make veterans eligible for VA coverage.

Recent veterans who served after 2001 were more likely to be uninsured than those who served before September 2001. Uninsurance was higher for younger veterans.

Uninsurance rates did not vary substantially for differences in sex or race and ethnicity, standing in stark contrast to nonveteran statistics. For example, non-Hispanic Black veterans were a third as likely to be uninsured when compared to nonveteran counterparts.

“Having served our country during their military service, veterans are owed access to health insurance coverage,” the brief stated.

The researchers offered four solutions to improve insurance rates among veterans.

First, state Medicaid programs should ensure that veterans are aware of their coverage options and eligibility. They should also offer better enrollment support. The public health emergency unwinding could provide the perfect environment to push for more outreach and enrollment support funding, given the fraught Medicaid redetermination process.

Additionally, the VA may need to improve its outreach efforts. The data showed that while uninsurance is lower among those who likely qualify for VA benefits due to their service-related disabilities, uninsurance was higher for low-income veterans despite income being a key factor in VA eligibility.

Third, Medicaid, ACA marketplace, and VA outreach efforts should focus on the groups of veterans who are most likely to be uninsured. These include veterans who are unemployed, unmarried, younger than 35, or who have a high school degree or less, among other factors.

Lastly, Medicaid expansion could help the remaining uninsured veteran population secure coverage. Over half of veterans live in nonexpansion states (52 percent).

“Evidence has shown that ACA Medicaid expansion and the establishment of Marketplaces with subsidies were associated with falling uninsurance among veterans, especially among the income groups targeted by new coverage options, and improvements in access to care,” shared the researchers.

The VA and ACA marketplace plans can cover many of the veterans who fall through the cracks of Medicaid eligibility requirements, but Medicaid tends to be more affordable and, as a result, may be more desirable for veterans. Veterans often cannot rely on the VA alone to cover all of their needs.