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News |
This means that 1.3 million Americans were added to the rolls of the uninsured last year, according to the most recent Census Bureau data, which were released August 29. Nearly 1 million of those affected were working adults 18–64 years of age, and the remainder were children.
The figures on insurance coverage continue a trend that began in 2000—a trend that many health policy experts would like to halt.
"Our health system does not work well for far too many families," Common-wealth Fund President Karen Davis said in a statement. "These findings point to the need for a national solution to ensure that all Americans have affordable and comprehensive health insurance coverage and access to needed health care."
"Our country desperately needs bold thinking and brave leadership to fix this crisis," echoed a statement from Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation. "The alternative is to continue to watch the inevitable, as the health care system of the United States ... slips further into a fractured state of haves and have-nots."
Kathleen Stoll, health policy director for the advocacy group Families USA, likewise decried the recent health coverage news. She stated that the numbers would have been worse without the availability of publicly financed insurance programs like Medicaid and called for steps to preserve those programs.
The proportion of insured Americans who received their benefits through Medicaid, Medicare, or other government-funded sources was unchanged from 2004 to 2005 at 27.3%, according to Census Bureau data.
Of those with insurance coverage in 2005, 59.5% received the benefit from an employer-sponsored health plan—a drop from the previous year, when 59.8% of insured Americans had health benefits through an employer. A declining proportion of Americans received medical coverage from other private sources; in all, private insurance coverage rates fell from 68.2% in 2004 to 67.7% last year.
David Johnson, chief of housing and household economic statistics for the Census Bureau, acknowledged during an August 29 media briefing that the entire increase in the uninsured rate was caused by the decline in private insurance coverage.
Putting a face on the numbers.
An issue paper published in August by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured found that three major national estimates of the uninsured population paint a reasonably consistent picture of the number and characteristics of uninsured Americans.
For example, the commission reported that estimates of the uninsured population for 2003 varied from 41.1 million, using data from the National Center for Health Statistics (NCHS), to 46 million, according to the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey, or MEPS. The Census Bureau estimate for that year fell in the middle, with an estimated 44.7 million people lacking insurance.
Although the Census Bureau reports that more Americans than ever lacked health insurance last year, the number of those with coverage also rose to a record high in 2005.
In all, 247.3 million Americans had health insurance coverage in 2005, an increase of 1.4 million over the previous year.
The seeming conflict in numbers is due to the fact that the U.S. population grows each year, resulting in increases in the overall number of those with insurance and those without coverage.
The Census Bureau estimates that the U.S. population grew by about 3 million from 2004 to 2005, to more than 296 million. After accounting for births, deaths, and migration, America’s population grows by about 1 person every 10 seconds, the Census Bureau estimates.
Differences in the figures are partly attributed to whether the survey defines people as uninsured if they lack insurance when interviewed, as NCHS does, or if they were uninsured for the entire year, as the Census Bureau does. The MEPS survey polls the same respondents at different intervals to determine insurance status and monthly coverage estimates over an extended period.
According to the Kaiser analysis, all three surveys agreed that adults account for about 80% of uninsured Americans. About 50–60% of uninsured working-age adults have incomes under 200% of the federal poverty level, the surveys find.
Also common to the surveys is the finding that the vast majority of uninsured adults—67–78%—work at least part-time but are not offered insurance by their employers or cannot afford employer-based coverage.
About a quarter to a third of uninsured adults did not finish high school, and about a third received their diploma but did not go to college. Jobs available to those with less than a college education are less likely than jobs open to more educated people to offer health insurance, the report noted.
Income and the great divide.
The Census Bureau report on health insurance coverage also included current statistics on income and poverty in the United States. Overall, the report stated, median household income was $46,300 in 2005, a 1.1% increase from 2004.
Despite gains in household income, median inflation-adjusted wages fell 1.8% for working men and 1.3% for women between 2004 and 2005. This marks the second consecutive year of wage declines for men and the third for women, Johnson said.
He attributed the overall gains in household income in the face of declining wages to the inclusion of investment income in household earnings and the fact that a household can contain multiple wage earners.
As in 2004, half of the nation’s overall household wealth gain went to those in the top 20% of the income spectrum, but just 3.4% went to the bottom 20%. Johnson called the top 20% of the income bracket the "great divide" in the nation’s income distribution.
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