The Uninsured

As insurance premiums rise and more employers drop coverage, an increasing number of Americans are living without health insurance. Nearly 90 million people—more than one in three non-elderly Americans—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:

Investing in Health Coverage: It Just Makes Sense explores four key reasons why we all have a stake in making sure everyone has health coverage. (June 2009)

Hidden Health Tax: Americans Pay a Premium discusses how private health insurance premiums are higher, in part, because the costs of uncompensated care for the uninsured are shifted to those who have insurance, a "hidden health tax." The report quantifies this "tax" for family and individual coverage. (May 2009)

CoverTN, Tennessee's Barebones Health Plan: A Case Study uses Tennessee's barebones health plan as an example to examine how limited-benefit plans fail to meet the health coverage needs of consumers. (May 2009)

Too Great a Burden: Americans Face Rising Health Care Costs reveals how many Americans face very high health care costs and shows the magnitude of the health care cost crisis. The report provides data on how many people are in families that will spend more than 10 percent or 25 percent of their pre-tax income on health care in 2009. (April 2009)

CHIPRA: The Children's Health Insurance Program Reauthorization Act - A Series of Issue Briefs. In February 2009, after a protracted political fight, Congress enacted, and President Obama signed, legislation that renewed CHIP through the end of 2013 and expanded its scope. These issue briefs examine the new provisions that were included in the reauthorization and how they will affect implementation in the coming months.

Health Care Must Be Affordable for All Families, Regardless of Income presents crucial arguments for why health reform must ensure that health care is truly affordable. It proposes placing reasonable limits on out-of-pocket costs and providing subsidies, especially for those with low and moderate incomes. (April 2009)

From the Campaign for America’s Future:

Healthy Competition: How to Structure Public Health Insurance Plan Choice to Ensure Risk- Sharing, Cost Control and Quality Improvement examines the debate over the effectiveness of the public plan option in health reform. It also suggests the most effective ways to implement a successful public plan model. (April 2009)

From the Center on Budget and Policy Priorities:

Rules of the Road: How an Insurance Exchange Can Pool Risk and Protect Enrollees finds that a strong exchange can greatly reduce the problems many people currently face when they must obtain coverage on their own without the help of an employer. It then lays out four key components of an efficient insurance exchange, including minimum standards for the benefits packages offered and a limit on the number of different benefit packages. (April 2009)

From the Commonwealth Fund:

Health Insurance and Health Care Access before and after SSDI Entry sheds new light on the experiences of people with disabilities and raises the question of why many people who are eligible for Medicare are denied coverage when they are perhaps most in need of it. While the cost of eliminating the waiting period seems high, it represents only a small percentage increase in Medicare spending, and it could help states reduce their spending on public coverage programs. (May 2009)

From the Council of Economic Advisers:

The Case for Health Reform provides an overview of how health care affects the economy and a forecast of where we will end up in the absence of reform that includes expanded coverage. If the annual rate of growth of health care spending is not reduced, the number of uninsured could rise to 72 million by the year 2040. (June 2009)

From Georgetown University’s Center for Children and Families:

The Last Piece of the Puzzle: Providing High-Quality, Affordable Health Coverage to All Children through National Health Reform provides a blueprint of what children and families need from health reform, including an overview of where gaps in children’s coverage remain. It also includes recommendations regarding the key challenges that must be addressed in order to complete the puzzle. (May 2009)

From Health Affairs:

Will Americans Support the Individual Mandate? presents national public opinion data and found that, on its own, an individual mandate does not have broad support across a politically diverse group of participants. The study did find, however, that policy makers who choose to pursue an individual mandate may expand their base of supporters by incorporating it into a "shared-responsibility" plan that includes requirements for employers, government, and insurers. (April 2009)

From the Kaiser Commission on Medicaid and the Uninsured:

Low-Income Adults under Age 65—Many Are Poor, Sick, and Uninsured examines the characteristics and insurance coverage of this group, which numbers more than 50 million. People in this group are more likely to be in poor health than other Americans and are the least likely to have health insurance. And because Medicaid coverage is extremely limited for adults without dependent children, a large share of low-income adults with significant health needs is uninsured. (June 2009)

The Coverage and Cost Impacts of Expanding Medicaid analyzes several options for covering more low-income uninsured people through Medicaid. It also explains how reductions in spending by firms and individuals for uncompensated care will help mitigate the costs associated with a Medicaid expansion. (May 2009)

From the Robert Wood Johnson Foundation and the Urban Institute:

Health Reform: Cost of Failure examines three different scenarios that could occur if the U.S. does not reform its health care system. It concludes that in the best case scenario, inaction could increase family and individual spending by at least 46 percent and nearly double government expenditures as more U.S. residents become eligible for programs such as Medicaid and CHIP. (May 2009)

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