The Uninsured

As insurance premiums rise and more employers drop coverage, an increasing number of Americans are living without health insurance. Nearly one in three non-elderly Americans—86.7 million people—went without health coverage for all or part of 2006-2007. And four out of five of those individuals were in working families.

Why does insurance matter? People without insurance are more likely to go without preventive care, to delay or forgo medical care, and to die prematurely. When sick, the uninsured may turn to emergency rooms for care, where oftentimes they are charged more for services than insured patients. And when uninsured patients can’t afford their medical bills, the cost of this care is passed on to the insured in the form of higher premiums.

This section of our Web site explores who is uninsured and how we can increase coverage.

The Latest

From Families USA:

Your Medical Bills: A Consumer's Guide to Coping with Medical Debt covers steps for paying your medical bills, understanding your rights, and other information you need to know if you are struggling with medical debt. The guide also includes links to many useful online resources. | Fact Sheet | State Protections (November 2009)

One-Two Punch: Unemployed and Uninsured takes a more in-depth look at the link between unemployment and uninsurance to get a clearer picture of the crisis of the uninsured. The report provides state-by-state numbers showing the likely magnitude of the increase in the uninsured due to rising unemployment. (October 2009)

Help for Small Businesses discusses how small businesses face a disadvantage when it comes to providing health insurance and how health reform will help remedy this situation. | Comparing the Small Business Tax Credit Provisions in the House, Senate HELP Committee, and Senate Finance Committee Bills (October 2009)

Medicaid and the Children's Health Insurance Program (CHIP) Soften the Blow during Tough Economic Times discusses how these programs have served as an effective health care safety net for many newly uninsured families, particularly for children. (October 2009)

Health Coverage in the States: How Will Health Reform Help? analyzes how the House health reform bill, America's Affordable Health Choices Act of 2009, would address many of the gaps and problems in the health care systems of specific states. (September-October 2009)

The Essential Benefits Package in the House Health Reform Bill (H.R. 3200) examines the proposed benefits package for the plans in the exchange, discusses the benefits committee and its responsibilities, and outlines issues that advocates should monitor as health reform moves forward. (September 2009)

Bridging the Gap: How Health Reform Will Help 55- to 64-Year-Olds discusses how the health reform legislation currently before Congress will make insurance more available and affordable for 55- to 64-year-olds and provide coverage stability for this age group. (September 2009)

Health Coverage in Communities of Color: Talking about the New Census Numbers takes a closer look at the latest data and finds that communities of color continue to bear the brunt of the uninsured crisis. This fact sheet looks at who is uninsured, poverty levels of different racial and ethnic groups, and why public programs are vital to communities of color. (September 2009)

Aiming Higher: Results from a State Scorecard on Health System Performance, 2009 finds rising health care costs are making coverage less affordable across the country. The report projects that these costs are also likely to widen gaps in access based on income, insurance status, or race/ethnicity. These nationwide problems underscore the need for comprehensive national reform to expand and improve the quality of coverage. (October 2009)

Out of Options: Why So Many Workers in Small Businesses Lack Affordable Health Insurance, and How Health Care Reform Can Help examines why small businesses often have more difficulty offering their employees health insurance, as well as how the economic downturn has intensified the problem. The brief also outlines how measures in the health reform proposals, such as the creation of an exchange and tax credits for small businesses, could help small businesses and their employees gain access to affordable, comprehensive coverage. (September 2009)

The Risk of Losing Health Insurance over a Decade: New Findings from Longitudinal Data reveals that nearly half of all Americans under the age of 65 go without health insurance in a 10-year period. In fact, 36 percent will go without coverage for at least one full year during that period. Given the frequency of gaps in coverage among Americans under 65, the study concludes that, without health reform that expands coverage, these trends are likely to worsen in the years to come. (September 2009)

Changes in Health Insurance Coverage, 2007-2008: Early Impact of the Recession indicates that the sharp decrease in coverage over this time period (1.5 million newly uninsured adults) was largely due to declines in job-based insurance. Coverage through public programs has bridged some of this gap, but increases in coverage for children were substantially larger than for adults. (October 2009)

From the Kaiser Family Foundation:

In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts details how the state’s health reform legislation has achieved near-universal coverage (94.7 percent) by combining a foundation of public coverage with greater access to private insurance through employers. While some budgetary challenges remain, the program has been largely successful, including a marked increase in job-based coverage. (September 2009)

From the Robert Wood Johnson Foundation

The Cost of Failure to Enact Health Reform examines the repercussions of not passing health reform in three scenarios—worst, intermediate, and best case—each based on different projected growth rates in income and health care costs. This state-by-state analysis shows that without reform, the percent of uninsured individuals will increase, job-based coverage will continue to deteriorate, spending on public programs will expand, and out-of-pocket costs could increase by more than 35 percent. (September 2009)

From the Robert Wood Johnson Foundation and the Urban Institute:

Health Reform in Massachusetts: An Update on Insurance Coverage and Support for Reform as of Fall 2008 provides an update of the impact on working-age adults, the primary target of reform policies, as well as an update on public support for health reform. The state has achieved its goal of near universal health coverage, and residents continue to show strong support for health reform, despite the rising costs of the program. (September 2009)

From the Urban Institute

Variation in Insurance Coverage across Congressional Districts: New Estimates from 2008 reveals which districts face the greatest deficiencies in private coverage and where public coverage has been able to close some of these gaps. Rates of private coverage are lowest in districts that have higher poverty rates, and despite above-average rates of public coverage in these areas, lack of insurance continues to be a serious problem. (October 2009)

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