Graduate Capstone Project
Population & Economic Dynamics in Puerto Rico
A graduate research project examining demographic shifts, out-migration, and sustainable development strategies through linked data analysis and policy synthesis.
Health Coverage Details
- Latest Year (2023): —
- Change since 2013: —
- Latest Annual Change: —
Percentage Without Coverage Trend (2013–2023)
Annual Change in Coverage Gap (pp)
Comparison of Coverage Gap Change by Period (pp)
Understanding the Health Coverage Trend
The striking, massive drop in the uninsured rate shown between 2014 and 2015 is not solely a reflection of real-world improvement. It is a combination of two major factors:
- Policy Effect: The implementation of the Affordable Care Act (ACA) and the corresponding expansion of government-funded healthcare (*Mi Salud*) in Puerto Rico dramatically increased public coverage, moving a large uninsured population into the insured category.
- Data Discontinuity: The drop was amplified by a major methodological change in the U.S. Census Bureau's American Community Survey (ACS) starting in 2015. New, clearer questions were introduced that effectively captured public health insurance enrollment, whereas previous surveys often missed this information, leading to an artificially high "uninsured" rate before 2015.
Analyzing Post-2015 Volatility
Since 2015, the uninsured rate has stabilized in the low single digits (4%–8%). However, the annual bar chart shows high volatility—small changes in this low rate result in noticeable positive or negative absolute percentage point swings. This suggests that the remaining uninsured population is highly susceptible to local economic shocks and mobility:
- Small Denominator Effect: Because the rate is so low, minor shifts in the number of uninsured individuals (the numerator) or the population (the denominator) can exaggerate the apparent percentage point change.
- Economic and Migration Shocks: Post-2017 (Hurricane Maria) and during the COVID-19 pandemic, sudden job losses, business closures, and high migration rates created rapid, temporary shifts in employer-provided and public coverage, causing the year-to-year swings seen in the municipal data.
- Hard-to-Reach Population: The population remaining uninsured tends to be complex—often young, highly mobile, or self-employed—making their rate difficult to measure precisely and highly sensitive to local economic events.
Research References:
- Health Insurance Data: ACS Table S2701: Health Insurance Coverage Status
- Public Health Context: Puerto Rico Department of Health (Departamento de Salud) & CMS Medicaid & CHIP Scorecard.
- Processed Data Files: municipios_acs_health_2013_2023_wide.json