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:

At a Crossroads: Is Health Coverage Ahead for America? examines how the Senate health reform bill, the Patient Protection and Affordable Care Act, will affect health coverage. It provides state-specific numbers on how many people will gain coverage under the bill, as well as how many people will be uninsured without health reform. (December 2009)

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)

Establishing a Consumer Health Assistance Program in Your Community: Consumer health assistance programs provide valuable services to people who have questions about health insurance (such as Medicaid or private insurance) or who are having trouble getting access to health care. For information on establishing such a program in your community, click here.

Young, Uninsured, and Seeking Change: Health Coverage of Young Adults and Their Views on Health Reform found that almost half of young adults are uninsured at some time during the year. In the current economic climate, young adults are less likely to find jobs, especially jobs with health benefits, and are often dropped from their parents' insurance upon graduation from college or high school. Provisions in federal health reform legislation could significantly help this group get and keep health coverage. (December 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)

From the Commonwealth Fund and the California HealthCare Foundation:

COBRA Subsidies for Laid-Off Workers: An Initial Report Card indicates that enrollment in COBRA coverage has increased substantially, and reports show that most eligible people have heard about the subsidy. Unfortunately, many eligible people still can't afford COBRA coverage. In order to further increase enrollment, Congress should consider raising subsidies and further simplifying enrollment procedures. (December 2009)

The Extension of the COBRA Subsidy: An Update reviews the COBRA subsidy and key changes made since its extension in December 2009. The brief looks at the options available for people who may have dropped coverage in anticipation of the end of the subsidy or who paid the full premium after their nine months of receiving the subsidy expired. (December 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:

Focus on Health Reform: Issues for Structuring Interim High-Risk Pools discusses the creation of high-risk pools in federal health reform legislation for people who are denied private coverage based on their health status. The brief examines the current role of high-risk pools as a safety net for coverage and reviews key issues involved in implementing a national high-risk pool. (January 2010)

Racial/Ethnic Disparities in Access to Care among Children: How Does Medicaid Do in Closing the Gaps? examines how disparities among children in Medicaid compare with those among privately insured and uninsured children. The findings reveal that disparities in Medicaid were similar to those in the private insurance market, and although the majority of children fare well in terms of access, problems still persist for children trying to get access to the health care they need. (December 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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