The Alarming Growth in the Number of Uninsured

An issue attracting more attention is the alarming growth in the number of uninsured Americans.

A recent report for the highly respected non-partisan National Coalition on Health Care found that:
In 1997, 43.4 million Americans, 15.9 percent of the population, did not have insurance.
Over a three-year period, about 30 percent of the population — 80 million people — can expect to experience a gap in coverage lasting at least three months.
Forty-four percent of workers who lost their jobs can expect to experience a gap of coverage lasting at least one month.
Even with the strong economy continuing, the study projects that the number of uninsured will grow to 51 to 53 million – 20 percent of the population — by 2009.
The study concludes that there are 10 factors that are the “chief culprits”:
Employment-based coverage is declining.
Health insurance is too expensive. The price of individual health insurance has increased faster than family income and wages during the past 20 years.
Individually purchased health insurance is becoming prohibitively expensive. The price varies widely by age and health status. Some states have recently enacted individual health insurance rules that have significantly increased cost. It is not uncommon for family health insurance purchased on an individual basis to cost $3,000 to $8,000 per year.
Underlying healthcare costs continue to rise, driven primarily by the growth in technology and volume of procedures.
Faced with rising premiums, businesses have shifted costs to workers.
Service sector jobs are increasing faster than manufacturing jobs — service employers don’t offer health insurance as often as manufacturing employers.
The number of “contingent” workers is growing. Part-time, temporary and contract employees don’t generally have access to employer health insurance.
Minority and immigrant population groups are a growing part of the population and are less likely to be in jobs that offer coverage.
Welfare reform has reduced Medicaid coverage.
Employers are scaling back retiree coverage, often because of changes in accounting rules, leaving some pre-65 family members of retirees, or pre-65 retirees themselves, without coverage.
The greater attention to growth in the number of uninsured is leading to public and private sector proposals to alleviate the problem. Proposals include:
Granting greater access to medical savings accounts (Republicans).
Expanding or replacing Medicaid for the poor and near poor (Democrats).
Full deductibility of individual health insurance (Republican).
Subsidies for employers to add coverage (Democrats).
The marketing of stripped-down lower cost policies to the uninsured (Aetna).
Comprehensive programs to provide government vouchers for the poor to purchase cheap health insurance (Health Insurance Association of America).
Medicaid buy-in for those coming off disability and returning to the workforce (bipartisan).
With the economy booming and masking the impact of the uninsured, this is not a hot issue. But it will become one, especially if the economy falters and the number of uninsured grows even larger and the time between jobs without a health plan becomes longer than the current average of a month or two.