Insurance and the Uninsured

Despite a resurgent economy between 2004 and 2006, the number of uninsured Americans increased at a greater annual rate than it had during a period of poor economic conditions at the beginning of the decade, according to a study in Health Affairs.

The study found that declines in employer-sponsored coverage largely explained the increased number of uninsured during both periods. According to the researchers, the number of uninsured adults increased by a total of 8.7 million over both economic phases because the decline in employer coverage was not offset by a significant increase in public coverage.

While increased uninsurance rates among children between 2000 and 2004 were offset by a large growth in Medicaid and the State Children's Health Insurance Program, smaller growth within these programs during 2004-2006 caused uninsurance rates for children and the number of uninsured children to rise.

The researchers concluded that the rate of employer-sponsored coverage will continue to decline because of a variety of factors, including disproportionate increases in health insurance premiums and wages -- especially among low-income individuals -- and changes in employment and population migration (Holahan/Cook, Health Affairs, 2/20).