The Uninsured: A PrimerKey Facts About Americans Without Health Insurance
The Henry J. Kaiser Family Foundation; 36 pages
The Gist:
As members of Congress vote on controversial health-care reform legislation, the Henry J. Kaiser Family Foundation has analyzed Census data to provide a closer look at the people going without health insurance in the U.S. Their report, focused on people younger than 65, found 45.7 million "nonelderly" uninsured people in the U.S. last year (including the elderly, the number of uninsured was 46.3 million). Low-income adults without dependent children — who generally do not qualify for government programs such as Medicaid — were hit hardest. Despite heated rhetoric on the issue, immigrants are not driving the problem; 80% of the uninsured below 65 are native-born or naturalized citizens. The uncompensated cost of providing health care to the uninsured last year was $57 billion, three-quarters of which was picked up by the federal government.
Highlight Reel:
1. One in six are uninsured: The ranks of the uninsured in America under 65 grew by 700,000 to last year, due largely to layoffs and wage slashes accompanying the weak economy. Two million people lost their employer-sponsored health coverage in 2008 alone. Since 2000, the total number of uninsured has risen every year but one.
2. Most uninsured Americans work: Of those below 65 without insurance, eight in 10 are members of working families. Only 19% are in families with no one working. However, 62% of the uninsured have no education beyond high school, limiting their ability to boost their incomes or advance to jobs that may offer health care. The uninsured were three times more likely to have trouble meeting basic monthly expenses, like rent and food.
3. Unsurprisingly, the uninsured are in worse health: Of those without health insurance, 11% report being in fair or poor health, compared to 5% with private coverage. Nearly a quarter of the uninsured say they've forgone medical care in the past year due to its cost, compared with 4% who receive private care. As a result, the uninsured are more likely to be hospitalized for avoidable health problems.
4. Government programs are making a difference for children: Despite overall increases, the number of uninsured children fell by 800,000 to 8.1 million last year, thanks to expansions in Medicaid and state programs covering minors. (The total was 9.4 million in 2006).
5. Young adults with no children are especially vulnerable: Programs such as Medicaid and Medicare insure millions of parents, children and disabled. But low earners without dependent children are offered few resources when it comes to health insurance, and comprise 58% of uninsured Americans as a result. At 30%, those 19 to 29 have the highest uninsured rate.
6. Immigrants represent a minority of the uninsured: Eighty percent of those without health insurance are native-born or naturalized citizens. However, immigrants are more likely to be uninsured than legal residents. Racial minorities are also disproportionately represented; about one-third of Hispanics and one-fifth of blacks go without insurance, compared with 13% of whites.
The Lowdown:
Most people know that millions of Americans lack health insurance, but this report helps give that enormous group a human face. That many unemployed workers lack health insurance is not a surprise, but many of us may not realize that so many working people do as well — a troubling fact that lends credence to the reform efforts underway on Capitol Hill. Highlighting the plight of childless uninsured adults is also a welcome counterbalance to media coverage of the issue, which often focuses on uninsured children and families. Amid the grim statistics, the foundation mentions a bright spot: the fact that recent expansion of children's health-care programs has helped lower the number of uninsured children. The notion that young people should have access to adequate health care has long drawn bipartisan political support; reaching that same goal with adults has, until now, proven far more difficult to accomplish.
The Verdict: Skim.