Census Bureau: Number of U.S. Uninsured Rises to 47 Million Americans are Uninsured: Almost 5 Percent Increase Since 2005

Teddi Dineley Johnson

Nations Health. 2007;37(8) 

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For the sixth consecutive year, the number of Americans living without health insurance has risen, according to new U.S. Census Bureau data. Approximately 2.2 million people were added to the uninsurance rolls in 2006 — the largest one-year increase in the number of uninsured Americans since 2002.

Annual Census Bureau estimates released in August show 47 million people, or 15.8 percent of the U.S. population, were without health insurance during 2006 — a 4.9 percent increase. In 2005, census figures showed that 44.8 million people, or about 15.3 percent of the population, lacked health insurance coverage.

The number of uninsured Americans has increased 22 percent since 2000, at which time 38.4 million people lacked health insurance.

Fewer Americans had employer-based coverage in 2006, the new data show. The percentage of people covered by employer plans fell from 60.2 percent in 2005 to 59.7 percent in 2006, according to the report, "Income, Poverty and Health Insurance Coverage in the United States."

Also of note, more children were without health insurance in 2006, the census data showed. The percentage of uninsured children younger than 18 rose from 10.9 percent in 2005 to 11.7 percent in 2006. According to the data, children ages 12–17 were more likely to be uninsured than children younger than age 12.

In response to the new data, dozens of health care organizations, including APHA, issued statements criticizing the nation's troubled health care system and urging Congress to reauthorize and strengthen the State Children's Health Insurance Program, which was due to expire Sept. 30. More than 6.6 million children in the United States were covered by the federal children's program, known as SCHIP, at some point during 2006. Since Congress first authorized SCHIP in 1997, the number of uninsured children in America has fallen by 24 percent.

In an Association news release, APHA Executive Director Georges Benjamin, MD, FACP, called the new uninsurance rate "a travesty."

"Access to health care is critical, especially for children," Benjamin said. "Children who are uninsured are more than three times less likely to have seen a doctor in the last year, and have a higher incidence of preventable disease than insured children."

Benjamin urged Congress to "forward the strongest possible SCHIP bill to the president for his signature."

According to the Commonwealth Fund, the difficult nature of obtaining and keeping health insurance coverage in entry-level jobs has resulted in major increases in the numbers of uninsured younger adults ages 25–34 and uninsured older adults ages 45–64. The new census data revealed that those hardest hit in 2006 were families with incomes between $25,000 and $75,000, but even when family income exceeded $75,000, the numbers of uninsured Americans grew by 1.3 million in 2006, suggesting that family premiums are becoming increasingly unaffordable, especially when employers do not provide coverage, the organization stated.

However, Commonwealth Fund President Karen Davis, PhD, said the jump in uninsured children is the new data's "most disturbing" finding. The number of uninsured children younger than 18 rose from 8 million in 2005 to 8.7 million in 2006.

"That's a jump of 9 percent in one year, and all of this was attributable to a decline in employer coverage," Davis told The Nation's Health.

The numbers of uninsured children would have been much worse if Medicaid and SCHIP had not covered an additional 5 million children over the six-year period from 2000 to 2006, Davis said, "because it was a period when employers were really dropping dependent coverage."

Davis said earlier data show that employer coverage is much more limited for children at less than 300 percent of the poverty level, "so reauthorization of SCHIP, with adequate funding to cover uninsured children, is essential to prevent a reversal of progress made through public programs in the past six years," Davis said.

Among children, the likelihood of health care coverage in 2006 varied by poverty status, age and race. Children in poverty were more likely to be uninsured than the overall population of children. While 7.3 percent of white children were uninsured in 2006, 22.1 percent of Hispanic children lacked coverage, as did 14.1 percent of black children and 11.4 percent of Asian children.

Families USA, a national health care consumer advocacy group, said the "epidemic" of uninsurance has reached crisis proportions. The number of uninsured Americans exceeds the cumulative population of 24 states and the District of Columbia, said Kathleen Stoll, director of health policy for Families USA.

The data "underscore the critical role that public programs such as Medicaid and SCHIP play in providing a health care safety net for millions of Americans," Stoll said in a statement.

Despite SCHIP's earlier success in decreasing the number of uninsured children, the number of uninsured children rose for the second consecutive year in 2006, Stoll said, again pinning the increase on the decline in employer-based coverage.

"SCHIP resources must be increased to meet the health care needs of the increasing number of uninsured children," Stoll said.

The likelihood of having health coverage rises with income levels. However, while the nation's official poverty rate declined slightly for the first time this decade, decreasing from 12.6 percent in 2005 to 12.3 percent in 2006, the actual number of people in poverty in 2006 — 36.5 million — was not statistically different from 2005, according to the Census Bureau.

The number of uninsured full-time workers increased from 20.8 million in 2005 to 22 million in 2006, while the number of uninsured part-time workers, 5.6 million, remained the same as in 2005. The number of Americans insured by Medicaid and Medicare in 2006 also remained the same as in 2005, at 38.3 million and 40.3 million respectively.

Between 2005 and 2006, the number of U.S.-born residents who were uninsured increased from 33 million to 34.4 million. The number of foreign-born people who lacked coverage rose from 11.8 million in 2005 to 12.6 million in 2006. People living in the nation's "principal" cities in 2006 had a higher rate of uninsurance than people living in the suburbs, according to the data.

The Midwest had the lowest uninsured rate in 2006, with 11.4 percent of Midwesterners lacking coverage, as compared with 12.3 percent of people in the Northeast, 17.9 percent of people in the West and 19 percent of people in the South.

Based on a three-year average from 2004 to 2006, Texas was home to the highest percentage of uninsured people, with a staggering 24.1 percent of Texans lacking coverage. Conversely, the nation's lowest uninsurance rates in 2006 were in Minnesota, Hawaii, Iowa, Wisconsin and Maine.

For a copy of the census report, visit www.census.gov. For more news from The Nation's Health, visit www.thenationshealth.org.

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