Fewer Americans are opting for dual health insurance coverage, according to a new report from the U.S. Census Bureau. The organization recently released its new analysis data from the 2023 Current Population Survey Annual Social and Economic Supplement. The data show that the percentage of adults over the age of 65 with private health insurance and Medicare fell from nearly 48 percent in 2017 to approximately 40 percent in 2022.

The Census Bureau reported that this change in coverage is a reflection of more adults relying on Medicare coverage to pay for medical expenses, adding that the number of older adults relying on Medicare alone was also driven by a drop in the number of seniors receiving private coverage. According to the report, dual coverage rates have fallen every year, except for 2020 and 2021.

Adults aged 65 to 69 saw dual coverage decrease by 8.0 percentage points and Medicare alone increased 6.3 percentage points, according to the report. Adults aged 70 to 79 saw their dual coverage decrease by 9.2 percentage points to 40.4 percent and Medicare alone increased 7.9 percentage points to 46.9 percent. Adults aged 80 and older saw dual coverage decrease by 7.9 percentage points to 37.8 percent and Medicare alone increased by 7.6 percentage points to 50.8 percent.

The percentage of adults over the age of 65 receiving Medicare in 2017 was more than 10 percentage points lower than those with private and Medicare coverage. In 2022, this number rose by more than 5 percentage points. Meanwhile, the number of older adults with just private coverage remained consistent, climbing from 4.9 percent in 2017 to 5.3 percent in 2022.

Changes in employment status also played a significant role in access to coverage. More Americans than ever are remaining in the workforce past the age of 65, allowing for higher rates of private coverage and less reliance on Medicare. This was not enough to shift the decrease across all employment status in the rate of dual private and Medicare coverage between 2017 and 2022.

For older adults who work full-time, dual coverage dropped by 8.9 percentage points to 40.0 percent and Medicare alone increased 4.0 percentage points to 24.0 percent.

Older adults who worked part-time saw dual coverage rates decrease by 6.3 percentage points to 52.0 percent, however, Medicare alone increased 6.6 percentage points to 35.6 percent.

Older adults aged 65 and older who did not work saw dual coverage decline by 8.4 percentage points to 37.8 percent, and Medicare alone increased 7.7 percentage points to 49.2 percent. This was the only employment status group to have lower dual coverage rates than Medicare only rates in 2022.

Other factors affecting medical coverage have been a shift in the number of available public health insurance options, with more than 9 percent of adults over the age of 65 having some other form of government health insurance. A decline in private health coverage may also be affecting the quality of care, the Census Bureau reported, triggering Americans to seek out other medical plans and private health plans.