The Census Bureau recently reported that the number of Americans without health insurance rose in 2002 to around 43.6 million, up from 38.7 million in 2000 but below the record 44.3 million who were uninsured in 1998. With health care costs increasing, many public health advocates are worried that this number might rise further. Why do more than 43 million Americans lack health insurance? Who are they? A common assumption is that most uninsured Americans simply cannot afford the cost of coverage. However, the evidence points to other factors in many cases. For example, during the last decade, the ranks of the uninsured have increased among affluent households and decreased among low-income households. § From 1993 to 2002 the number of uninsured people in households with annual incomes above $75,000 increased by 114 percent. § The number of uninsured in households with annual incomes from $50,000 to $75,000 increased by 57 percent. § By contrast, the number of uninsured people in households with incomes under $25,000 fell by 17 percent. About three-quarters of the rise in the number of uninsured over the past four years has been among households earning more than $50,000 per year, and almost half of that has occurred among households earning more than $75,000 per year. In fact, almost one-third of the uninsured now live in households with annual incomes above $50,000 and one in five live in households earning more than $75,000 annually. Another common assumption is that most uninsured Americans simply have no access to affordable coverage. Yet according to research by the public policy arm of Blue Cross Blue Shield Association, approximately 14 million uninsured adults and children are currently eligible for government coverage, such as Medicaid or the State Children's Health Insurance Program (SCHIP), but have not bothered to enroll. Consider this: Virtually all children from low-income families are eligible for Medicaid or SCHIP. Yet the parents of more than five million eligible children have failed to enroll them. In addition, close to nine million non-elderly adults qualify for Medicaid but are not enrolled.
For more information, visit: http://www.ncpa.org/pub/ba/ba460/