INTRODUCTION

After a year of deliberation and debate, Congress is on the verge of passing historic health reform legislation. Despite broad consensus across the political spectrum that our health system urgently needs to be reformed, the fate of this legislation remains unclear. If this Congress fails to pass health reform, the consequences will be devastating, both for families who are without health insurance today and for those who are at serious risk of becoming uninsured in the near future. Quite simply, lives are on the line.

In 1994, when health reform was last debated, the number of uninsured Americans was nearly 40 million. Today, that number has risen to nearly 50 million. For these uninsured Americans, going without health coverage can have serious consequences. We know that the uninsured are too often burdened by medical debt, they delay care until their health problems grow severe and the cost of treatment escalates, and they often go without any care at all. And worst of all, people who lack coverage may die prematurely.

In 2002, the Institute of Medicine issued a groundbreaking report, Care without Coverage: Too Little, Too Late, which estimated that, nationwide, 18,000 adults between the ages of 25 and 64 died in 2000 because they did not have health insurance. Subsequently, The Urban Institute updated that figure, estimating that, in 2006, at least 22,000 adults in the same age group died because they did not have health insurance.

To find out how inaction would affect American families, Families USA generated state-level estimates of the number of deaths that will occur due to a lack of health coverage if health reform doesn’t pass. In addition, our report quantifies the number of Americans that died due to a lack of health coverage since the last effort to pass health reform in 1994.

To estimate the number of deaths due to the lack of health coverage, Families USA applied the methodology developed by the Institute of Medicine to state-level population and mortality data. Our report provides one measure of the consequences of the failure to enact health reform—there are many other serious consequences (see “Why Insurance Matters” on page 5).

As Congress and the public continue to debate health reform, our findings serve as a stark reminder that more is at stake than partisan politics: Delaying action on health reform will have deadly consequences.