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The Uninsured in America. Presentation to the Citizens’ Health Care Working Group May 11, 2005. Peter Cunningham, Ph.D. Center for Studying Health System Change. A Primer on the Uninsured . How many? How is it changing? Who are the uninsured? Consequences of being uninsured.

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the uninsured in america

The Uninsured in America

Presentation to the Citizens’ Health Care Working Group

May 11, 2005

Peter Cunningham, Ph.D.

Center for Studying Health System Change

a primer on the uninsured
A Primer on the Uninsured
  • How many?
  • How is it changing?
  • Who are the uninsured?
  • Consequences of being uninsured
how many uninsured are there
How Many Uninsured Are There?
  • Estimates vary

> Different surveys and methodologies

> Depends on length of time being measured

  • Coverage more fluid than estimates indicate
  • Many are uninsured for brief periods
length of time uninsured
Length of Time Uninsured

16%

45%

13%

26%

Source: CBO estimates from SIPP, 1996-1999

how is it changing
How is it Changing?
  • Uninsurance increasing for adults
  • Uninsurance decreasing for children
  • Shift from private to public coverage for low income persons
percent uninsured
Percent Uninsured

Source: EBRI estimates of the CPS

premiums are rising faster than earnings
Premiums are Rising Faster Than Earnings

Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits

low income adults 200 fpl
Low Income Adults (< 200% FPL)

Source: CTS Household Survey

low income children 200 fpl
Low Income Children (< 200% FPL)

Source: CTS Household Survey

who are the uninsured
Who Are the Uninsured?
  • Most in working families
  • ESI coverage not available
  • Low income, young adults, Hispanics at high risk
most uninsured in working families
Most Uninsured in Working Families

17.3%

60.4%

22.3%

Source: EBRI estimates from the CPS, February 2001 supplement

uninsured workers
Uninsured Workers

20%

13%

67%

Source: EBRI estimates from the CPS, February 2001 supplement

reasons eligible workers were uninsured
Reasons Eligible Workers Were Uninsured

6%

28%

66%

Source: EBRI estimates from the CPS, February 2001 supplement

reasons ineligible workers were uninsured
Reasons Ineligible Workers Were Uninsured

6%

33%

51%

10%

Source: EBRI estimates from the CPS, February 2001 supplement

most uninsured in small firms
Most Uninsured in Small Firms

Source: CTS Household Survey, 2003

most uninsured in low wage jobs
Most Uninsured in Low-Wage Jobs

Source: CTS Household Survey, 2003

most uninsured are low income
Most Uninsured Are Low-Income

Source: CTS Household Survey, 2003

young adults at high risk
Young Adults at High Risk

Source: CTS Household Survey, 2003

a major problem for hispanics
A Major Problem for Hispanics

Source: CTS Household Survey, 2003

noncitizens more likely to be uninsured
Noncitizens More Likely to be Uninsured

Source: CTS Household Surveys

consequences of being uninsured
Consequences of Being Uninsured
  • Reduced access -- more unmet medical needs
  • Higher ED use
  • More financial problems
  • Worse health outcomes
more unmet needs
More Unmet Needs

Source: CTS Household Survey, 2003

greater reliance on eds
Greater Reliance on EDs

Source: National Ambulatory Medical Care Survey, 2001

more financial problems
More Financial Problems

Source: CTS Household Survey, 2003