Uninsured population grows again in 2005
The problem of the uninsured is growing worse, according to U.S. Census Bureau data. The federal government estimates that nearly 46 million Americans lack coverage of any kind for an entire year. Other research shows that tens of millions more Americans go without health coverage for shorter periods of time.
Recent Census Bureau data demonstrate that the problem of the uninsured continued in 2005. According to figures released in August 2005, 45.8 million people—15.7 percent of the total U.S. population—were uninsured in 2004, up slightly from 15.6 percent in the previous year.
The percentage of the non-elderly population that is uninsured has climbed steadily from 15.9 percent in 1994 to 17.8 percent in 2004 (with a slight dip of no more than one percentage point around the turn of the century).
Nearly twenty percent of uninsured Americans—8.3 million individuals—are children. While children are more likely to be insured than non-elderly adults, health insurance is particularly important for children. Uninsured children are more likely than insured children to lack a usual source of health care, to go without needed care and to experience worse health outcomes.
Almost 4 in 10 (39.5 percent) of uninsured children are White, compared to 36.5 percent Hispanic and 17.1 percent Black.
Hispanic children are far more likely to be uninsured (21.1 percent) than non-Hispanic White children (7.6 percent), Black children (13.0 percent), and Asian children (9.4 percent).
3 in 10 children (29.4 percent) without coverage are under six years old.
Almost 1 in 3 uninsured (31.9 percent) children live in families below the poverty line. Another one-third (30.9 percent) live in families making between 100 percent and 200 percent of poverty.
Two-thirds (66.2 percent) of all uninsured children live in households in which the family head is employed full-time throughout the year, 66 while only 16 percent of all uninsured children live in households headed by a family head who did not work the previous year.
Having a job, even a full-time job, does not guarantee access to health insurance.
Non-elderly full-time workers are more likely to have insurance than non-elderly part-time workers, who are more likely to have insurance than non-elderly non-workers. Among the non-elderly poor, the opposite is true. Non-workers are more like to be insured than part-time workers, who are more likely to be insured than full-time workers.
More than eight in ten of the non-elderly uninsured (83.3 percent) live in families where the head of the family works.
Over one-half (57.3 percent) of all uninsured working adults are employed full-time throughout the year.
Despite having the highest health care spending per capita, the U.S. consistently scores at or near the bottom in comparisons with other developed, high income countries on infant mortality, life expectancy, and the proportion of the population with health insurance coverage (OECD, 2002, WHO, 2000). Almost everyone in these countries has coverage. In the U.S., by contrast, 15.7 percent of the population—or 45.8 million people—were uninsured in 2005.
What are the consequences of 37.5 million adults and 8.3 million children living without health insurance coverage?
In a sweeping 6-volume series on the consequences of uninsurance, the Institute of Medicine reported the following conclusions:
Compared to people with insurance, uninsured children and adults experience worse health and die sooner.
Families can suffer emotionally and financially when even a single member is uninsured.
"Uninsurance at the community level is associated with financial instability for health care providers and institutions, reduced hospital services and capacity, and significant cuts in public health programs, which may diminish access to certain types of care for all residents, even those who have coverage."
The nation as a whole is economically disadvantaged as a result of the poorer health and premature death of uninsured Americans. The IOM estimated that the lost economic value of uninsurance is between $65 billion and $130 billion annually.
National surveys consistently show that the high cost of health insurance is the primary reason people are uninsured.
Only 9 percent of people in families with income over $50,000 per year are uninsured, compared to 40.8 percent of people with family income below $5,000.
One-quarter of the uninsured live below the poverty level, which was $9,827 for a single adult and $19,484 for a four-person household in 2004, and over one-half (54 percent) live below 200 percent of the poverty level.
People with family income below 200 percent of the poverty level are nearly twice as likely to be uninsured as the nonelderly population in general.
Income is an important determinant of insurance status, the number of wage earners in a family and the relative sizes of their salaries matters. For instance, a family with two wage earners, each making $30,000 a year, may be less likely to be offered employment-based insurance than a family with 1 wage earner making $50,000 a year.
One-third of the difference in insurance rates between families that earn less than 100 percent of the poverty level and those that earn more than 200 percent of poverty would be removed if the two groups were alike in terms of health status, geographic region, and demographic characteristics.
Employment-based health insurance continues to be the predominant source of coverage for the non-elderly population.
Almost two-thirds (62.4 percent) of the non-elderly population had employment-based health insurance in 2004. About one-half were covered in their own name and about one-half received coverage as a dependent.
Only 6.8 percent of the non-elderly population purchases insurance in the individual market (otherwise known as the non-group market).
17.5 percent of the non-elderly population gets coverage from public sources (Medicaid, Medicare, and the health care systems for active and retired military personnel and their families).
In 2004, 45.5 million (17.8 percent) non-elderly people were uninsured.
A national survey conducted in 2003 found that almost six in 10 uninsured adults (59 percent) have been without health insurance for two years or more.
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