UNINSURED I: Economy Credited for Declining Numbers
After rising "relentlessly," at an average rate of one million per year between 1987 and 1998, the number of uninsured Americans dropped last year by 1.7 million to 42.6 million, according to the Census Bureau. The New York Times reports that the proportion of individuals without insurance also declined for the first time since 1987, from 16.3% in 1998 to 15.5% in 1999 (Pear, New York Times, 9/29). In California, the number of people covered by their employers jumped by 1.2 million between 1998 and 1999 -- the biggest increase in a decade, the San Francisco Chronicle reports (Freedberg, 9/29). Charles Nelson, an official in the bureau's income, poverty and health division, said, "I would never call one year a trend. But the fact that it's never happened since we've been measuring it, including in some pretty strong economic years, makes me consider it a pretty significant finding." The Census Bureau report, based on a survey of 50,000 households, also illustrated the following statistics from 1999:
- About 11% of non-Hispanic whites lacked insurance in 1999, a decline of one percentage point from 1998;
- About 33% of Hispanics lacked insurance, a drop of two percentage points from 1998;
- 21% of blacks, Asians and Pacific Islanders lacked insurance, but the figure is "not significantly different" from 1998;
- 14% of native-born Americans lacked insurance, compared to 33% of foreign-born Americans;
- About 63% of Americans had employer-based insurance, an increase of about one percentage point;
- About 60% of the "non-working poor" were insured, compared with 53% of people below the poverty level, but with jobs;
- 14% of children under age 18 were uninsured, a decline of one percentage point (Brown, Washington Post, 9/29);
- 29% of people ages 18-24 were uninsured. That age group was less likely than any other age group to have insurance in 1999 (New York Times, 9/29);
- Minnesota, Rhode Island and Hawaii had the smallest proportion of uninsured residents, at about 9% each (Washington Post, 9/29);
- 25.8% of New Mexico residents were uninsured, the highest percentage in the nation; Texas (23.3%), Louisiana (22.5%), Arizona (21.2%) and Nevada (20.7%) followed in highest percentages of uninsured residents (Rosenblatt/Rubin, Los Angeles Times, 9/29).
Analysts credited a "robust" economy and the expansion of government programs, such as CHIP, for the decline in the uninsured population. Statistician Robert Mills said, "The driving force behind this improvement was an increase in the likelihood of people having employment-based health insurance" (New York Times, 9/29). Paul Fronstin, an economist with the think-tank Employee Benefit Research Institute, said, "As long as the strong economy sticks around, I expect to see more and more people covered by employer-based health insurance coverage, regardless of what happens with health insurance costs. Employers need health benefits to recruit and retain workers ... -- and that will have a much bigger impact on them than the rising cost of insurance" (Los Angeles Times, 9/29). According to a recent survey from the Kaiser Family Foundation, only 54% of firms with fewer than 200 employees offered health insurance benefits in 1998, but that proportion increased to 67% in 2000. Furthermore, 60% of businesses with three to nine employees offered health benefits in 2000, compared to 49% in 1998 (Pugh, Philadelphia Inquirer, 9/29). Last year, the number of people with employer-based health insurance rose by 3.4 million to 172 million. The New York Times reports that change accounted for "85% of the increase in the number of people with health insurance." In addition, the Census Bureau cited programs such as CHIP and Medicaid for helping increase coverage among "poor children and youngsters with family income just above the poverty level," but added that overall, there was no change in the proportion of the population covered by such programs (New York Times, 9/29).
Health policy experts and government officials voiced praise and caution for the new figures. Sen. Ted Kennedy (D-Mass.), an "early proponent" of CHIP, lauded the government-administered program, and said that Congress should expand such programs to cover parents of already enrolled children. President Clinton also "welcomed" the new figures, saying, "I am extremely pleased with today's announcement. I believe it validates our health care and economic policies." But the New York Times notes that the number of uninsured is still three million higher than what it was when Clinton took office 1993 (New York Times, 9/29). Diane Rowland, director of the Kaiser Commission on Medicaid and the Uninsured said that "nothing magical has happened to turn around the problem. ... The great concern is what will happen if the economy turns sour, or we have a real recession, in which historically health insurance coverage has eroded" (Washington Post, 9/29). Ronald Pollack, executive director of the consumer group Families USA said, "The new Census Bureau numbers are welcome news, but no cause for celebration. It's like a morning drizzle after a prolonged drought" (New York Times, 9/29). The Census Bureau report is available at http://www.census.gov/prod/2000pubs/p60-211.pdf.
New Kaiser Report
In preparation for the new statistics, the Kaiser Family Foundation released a report, "In Their Own Words: The Uninsured Talk about Living Without Health Insurance," that offers profiles of eight uninsured families in the United States. The report, fact sheets and chartbook are available at http://www.kff.org/docs/sections/kcmu/uia2000.html.