Uninsured Middle Class Driving Health Care Debate
The growing number of individuals who are "[s]olidly middle class" and lack health insurance is "one reason ... that the problems of the uninsured have jumped to the top of the domestic political agenda in Washington and on the campaign trail," the New York Times reports. More than one-third of the uninsured in the U.S. have annual family incomes of more than $40,000, according to the Employee Benefit Research Institute.
Although the federal government does not have an official definition of "middle class," a common point of reference is median household income, which was $46,326 in 2005. More than two-thirds of the uninsured live in a household with one full-time worker.
Increasing numbers of uninsured in the middle class can be attributed to the rising cost of health care, a decline in manufacturing jobs and an increase in workers employed in the service industries and small businesses, which are less likely to provide insurance, according to Katherine Swartz, a professor of health policy and economics at Harvard University.
Without an employer to provide health insurance, a worker must buy an individual plan or go without coverage altogether.
Janet Trautwein, executive vice president of the National Association of Health Underwriters, said that an employee group plan "covers a mix of sick and healthy workers," adding, "By contrast, individuals and independent contractors are more likely to defer coverage until they need it, so the pool of people insured is, overall, less healthy. Sick people consume more health care. As a result, the cost to insure them is higher."
Uninsured individuals with pre-existing conditions also face difficulty obtaining insurance, despite a federal law limiting the ability of health plans to discriminate based on people's illnesses.
Karen Pollitz, a research professor at the Georgetown University Health Policy Institute, said, "In the individual market, the federal protections provide precious little help to people seeking coverage" (Pear, New York Times, 3/5).