Who are the Uninsured and the Impact of Lack of Insurance

Who are the uninsured?
Over 45 million Americans are without health insurance and nearly 30 million more are underinsured.

Employers are not providing healthcare coverage to millions of their employees. The American healthcare system is based on the assumption that employers will provide health insurance coverage to employees. But 85 percent of those without health coverage are in families with working parents. Seventy percent of uninsured workers are not even offered health coverage by their employers. Of the rest, 84 percent cite the high cost of health insurance premiums as the reason for declining coverage. Only 55 percent of low-wage workers—those earning under $7 per hour—have access to job-based health insurance. (Maryland Citizens Health Initiative)
According to Citizen Action, More than 5.6 million New Yorkers, one-out-of three people under the age of 65, did not have health coverage for all or part of 2002-2003, according to a new report released today by Citizen Action of New York. Most of these New Yorkers, 65%, went without health insurance for six months or longer.

Latinos and African Americans in New York are more likely to be uninsured than whites. More than half (56%) of Latinos and 43% of African Americans did not have health insurance for a portion of 2002 and 2003, compared to 23% of whites. Still, white New Yorkers made up the highest number of uninsured, 2.3 million.

Three-out-four of people who were uninsured in New Yorkers are working. While 60% made less than two times the federal poverty level another 40%, or 2.4 million New Yorkers, earned more then two times the federal poverty level but still went without health insurance for some portion of 2002-2003 (Citizen Action)

Nationwide, the Commonwealth Fund reported that the 4 million national increased in the number of uninsured from 2001 to 2003 was due to a decline in employer sponsored health insurance coverage. While seventy-two percent of workers had health insurance
through employers, most workers without employer-based coverage are uninsured because there are few sources of affordable coverage outside the employer-based system. he lower workers’ wages are, the less likely it is that they have health insurance
through their jobs. Eighty-eight percent of employees earning more than $15 per hour had
employer-sponsored insurance, but only 41 percent of those earning less than $10 per hour had such coverage. The lowest wage earners are the most likely to be uninsured: 46 percent of this group was uninsured for all or part of the year - even when jobs come with health benefits.

A 2003 Commonwealth Fund/Health Research and Educational Trust survey of 576 New York State firms found that, in order to manage rising health costs, employers are increasing the share of the insurance premium that employees pay, delaying the start of benefits, and increasing cost-sharing at the point of service. This has enabled employers to preserve health benefits, but has raised costs for workers and their families. On average, workers' contributions for family coverage rose 54 percent, from $1,392 per year in 2001 to $2,148 per year in 2003. During that time period, fewer workers selected family coverage.

Individuals with pre-existing and potentially expensive medical conditions also constitute many of the uninsured. The average American insurance company rejects 18% of all applicants for medical reasons, ranging from HIV infection to such trivialities as chronic back pain or attention deficit disorder. (AMSA)

Impact of Lack of Insurance

Every year, 18,000 Americans die prematurely because they don’t have health insurance, according to a comprehensive report by the National Academy of Sciences’ Institute of Medicine. Since they receive inadequate health care and their major illnesses are diagnosed too late, the uninsured become sicker and die sooner. In one study conducted over a period of 17 years, the uninsured were 25 percent more likely to die than those with private insurance.
The current system for providing medical care to the uninsured drives up healthcare costs for everyone else. When the uninsured do receive care, it is often at hospital emergency rooms and urgent care clinics—costly and inefficient places to provide primary care. Facilities that treat the uninsured provide nearly $100 billion in healthcare services each year. To pay for unreimbursed costs, these facilities have to increase costs to public and private insurance programs, driving up rates for everyone. (Maryland Citizens Health Initiative)
Many people believe that the uninsured receive adequate charitable care (e.g., from hospitals). However, 33.7% of the uninsured are still unable to obtain necessary health services and 71% delay seeking needed care for financial reasons. From AMSA.

Because of gaps in insurance coverage, only 60% of women who ought to have routine mammograms have this potentially life-saving procedure.

A recent Kaiser Family Foundation study indicated that 20% of those surveyed skipped or reduced dosage of needed medications because they could not afford prescription drugs. This figure translates into more than twenty millions Americans.

Access to health care is directly related to income and race in the United States. As a result the poor and minorities have poorer health than the wealthy and the whites.