The Uninsured in America Peter Cunningham, Ph.D. Center for Studying Health System Change Presentation to the Citizens’ Health Care Working Group May 11,

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Presentation transcript:

The Uninsured in America Peter Cunningham, Ph.D. Center for Studying Health System Change Presentation to the Citizens’ Health Care Working Group May 11, 2005

A Primer on the Uninsured  How many?  How is it changing?  Who are the uninsured?  Consequences of being uninsured

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

Estimates of the Uninsured, 2003 (in millions) Point-in Time Full Year Any Time in Year CPS MEPS NHIS CTS

Length of Time Uninsured Source: CBO estimates from SIPP, % 45% 13% 16%

How is it Changing?  Uninsurance increasing for adults  Uninsurance decreasing for children  Shift from private to public coverage for low income persons

Percent Uninsured Source: EBRI estimates of the CPS

Premiums are Rising Faster Than Earnings Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits

Low Income Adults (< 200% FPL) Source: CTS Household Survey

Low Income Children (< 200% FPL) Source: CTS Household Survey

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 Source: EBRI estimates from the CPS, February 2001 supplement 60.4% 17.3% 22.3%

Uninsured Workers Source: EBRI estimates from the CPS, February 2001 supplement 67% 20% 13%

Reasons Eligible Workers Were Uninsured Source: EBRI estimates from the CPS, February 2001 supplement 66% 28% 6%

Reasons Ineligible Workers Were Uninsured Source: EBRI estimates from the CPS, February 2001 supplement 33% 51% 10% 6%

Most Uninsured in Small Firms Source: CTS Household Survey, 2003

Most Uninsured in Low-Wage Jobs Source: CTS Household Survey, 2003

Most Uninsured Are Low-Income Source: CTS Household Survey, 2003

Young Adults at High Risk Source: CTS Household Survey, 2003

A Major Problem for Hispanics Source: CTS Household Survey, 2003

Noncitizens More Likely to be Uninsured Source: CTS Household Surveys

Consequences of Being Uninsured  Reduced access -- more unmet medical needs  Higher ED use  More financial problems  Worse health outcomes

More Unmet Needs Source: CTS Household Survey, 2003

Greater Reliance on EDs Source: National Ambulatory Medical Care Survey, 2001

More Financial Problems Source: CTS Household Survey, 2003