THE UNINSURED: Low-Income in Trouble Despite Economy
A new Commonwealth Fund study out last week reports that nearly 20% of working Americans earning under $35,000 are without health insurance, go without needed care, face collection agencies for unpaid bills and report poor health -- all despite a recordbreaking economy and low unemployment rates. "Can't Afford to Get Sick: A Reality for Millions of Working Americans," a report analyzing the Commonwealth Fund 1999 National Survey of Worker's Health Insurance, also shows that middle- and higher-income Americans still have trouble receiving necessary medical care and paying their health bills. While nearly one in five (19%) working-age adults lack insurance, two in five (41%) adults earning less than $20,000 have no insurance. Those with incomes more than $35,000 fare better, with only 7% uninsured. Those with below-average incomes often lack insurance because it is not provided by their employer: at least 42% of employees making less than $20,000 are not offered insurance through their employer or are not eligible to participate in the company's plan.
Widening Racial Gap?
Of those surveyed, Hispanics appear to be at a particularly high risk of being uninsured. Compared to African Americans (17% not offered employer-based insurance) and whites (18%), 34% of Hispanics do not have access to insurance. Without insurance, these individuals are less likely to fill a prescription, get a recommended test or treatment or visit a doctor.
Medical bills add a significant burden to those who consider their financial situation as having "just enough" or "not enough." More than half of those who make less than $20,000 and 30% of adults in the $20,000 to $35,000 bracket could not pay their medical bills in the last year. The survey estimates that at least 31 million were contacted last year by a collection agency for unpaid medical bills. Even those with higher incomes suffered. One in four people who earn between $20,000 and $35,000 were contacted by collection agencies, as were 14% of those with incomes between $35,000 and $60,000.
The Fund's Next Steps
"We have to recognize that our system of providing health insurance often does not work well for millions of working Americans," said Karen Davis, president of The Commonwealth Fund. She added, "[W]e need to look for solutions that could enhance opportunities for working men and women to lead healthy, productive lives." Toward this goal, the organization has formed the Task Force on the Future of Health Insurance for Working Americans, composed of nationally-recognized individuals in the business, government, public policy, economics and medical fields. The report analyzed survey responses of 5,002 Americans between the ages of 18 and 64 (Commonwealth Fund release, 9/2).