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Census: 45 million Americans now lack health insurance. (cover story)
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Author: Krisberg, Kim
| Census: 45 million Americans now lack health insurance |
Number of uninsured jumps by 1 million
MORE THAN A MILLION
Americans were added to the rolls of those without health insurance in
2005, bringing the nation's total of uninsured to 45 million, according
to the newest figures from the U.S. Census Bureau.
The latest numbers
bring the rate of uninsured people to almost 16 percent of the U.S.
population, with the number of those covered through employer-based
health insurance falling by more than a million between 2002 and 2003,
according to "Income, Poverty and Health Insurance Coverage in the
United States: 2003," which was released in late August by the U.S.
Census Bureau. For those working full-time, the uninsured rate rose
from 16.8 percent to 17.5 percent. The number of uninsured children
remained stable from 2002 to 2003 at more than 8 million, said Daniel
Weinberg, chief of the Housing and Household Economic Statistics
Division at the Census Bureau during an Aug. 26 news conference in
Suitland, Md.
Enrollment in
government health care programs increased between 2002 and 2003 from
more than 73 million to more than 76 million people, with Medicaid --
the federal health care program for low-income families -- undergoing a
jump of 2 million more enrollees. Those covered under the state
Children's Health Insurance Program also rose, according to Weinberg,
who noted that while child poverty rose in the United States in 2003,
numbers of uninsured children remained stable -- a sign that CHIP has
helped break the relationship between poverty and uninsurance.
Nevertheless, children living in poverty -- the number of which rose to
12.9 million in 2002-2003 -- were the most likely to be uninsured, the
report found.
"The issue is getting
worse, not better," said Georges Benjamin, MD, FACP, APHA's executive
director, in an Association news release. "How many more studies and
reports do we need showing the rise in the uninsured before we take
action? Solving the crisis should be a top priority for our elected
leaders."
Other data from the
new Census report show that in 2003, uninsurance numbers rose among
whites as well as Hispanics -- with 21 percent of Hispanic children
uninsured -- but rates were unchanged for blacks, Asians, American
Indians and Alaska Natives. Chances of having health insurance rose
with income level, the Census Bureau reported, but unfortunately the
U.S. poverty rate also rose by more than 1 million people in 2003.
Among different population groups, poverty rose for whites and Asians,
while for children younger than 18, both the poverty rate and number of
those living in poverty increased in 2003. Also, while the earnings of
U.S. men have remained stable, women have witnessed their first
earnings decline since 1995, Weinberg said. In fact, according to an
analysis of the Census figures by the National Women's Law Center, the
uninsured rate for women was twice as high as that of men from
2002-2003.
"An increase to 45
million uninsured Americans only means a higher burden on all of us,"
said Kathleen Stoll, JD, MA, director of health policy at Families USA,
a health care consumer advocacy organization. "It's definitely a
significantly greater burden on our emergency rooms and health care
safety net providers."
When uninsured people
turn to hospitals for needed care, the cost of that care is eventually
paid by the public, as hospitals absorb such costs into their overall
rate structures, Stoll told The Nation's Health.
"People who are
fortunate enough to have health insurance are beginning to see the
relationship, but we have to continue to educate people that these are
interrelated problems," she said.
Stoll said that
although it's difficult to find a silver lining in the recent Census
figures, increased enrollment in public health care programs
underscores the importance of protecting Medicaid, Medicare and CHIP.
Such programs are essential in filing in gaps left by private coverage
losses, she said. However, in many states, a full-time worker earning
minimum wage -- about $11,000 a year -- in a family of three makes too
much money to qualify for Medicaid, said Stoll, who called for widening
access to public health care programs for low-wage workers. State CHIP
programs may offer coverage for children living at or below 200 percent
of the poverty level, but that doesn't mean parents will also be
covered.
"We need to raise eligibility levels for parents so we're insuring whole families and not just children," Stoll noted.
Only about half of
uninsured children had a well- child check-up in the past year, and
uninsured children are nine times as likely as their counterparts to
lack a regular health care provider, according to figures released in
early August by the Centers for Disease Control and Prevention.
Medicaid and state CHIP programs have been responsible for a
significant decrease in uninsured children from 2001 to 2003, but such
gains are also contingent on state budgets, many of which have been
struggling to keep up with costs.
"As the fiscal
pressure on states lightens a little bit, we are seeing some states
that are willing to move ahead (with expanding programs)," said Karen
Davis, president of the Commonwealth Fund, which supports independent
research on health and social issues. "But it's basically something
that's very tough for states to do on their own without federal fiscal
help."
Many assume that the
uninsured receive needed care through free community clinics and
hospitals, but that varies widely, Davis told The Nation's Health. For
example, community health workers bump into trouble when trying to
refer uninsured patients for more specialized care. And although the
uninsured receive catastrophic care, such as in the event of a heart
attack or car accident, they often have no access to preventive
services, such as Pap smears and cancer screenings, or care for the
management of chronic health conditions.
"The things that
really give you an opportunity for a healthy, productive life are often
denied to people who don't have health insurance coverage," Davis said.
Both Davis and Stoll
said an employer-based health care system Works well for many
Americans, but that employers are feeling the immense strains of high
health care costs as well. Both said employers will need assistance to
continue offering health benefits to employees.
For a copy of the recent U.S. Census report on uninsurance, visit <www.census.gov>. For more on uninsurance, visit <www.familiesusa.org> or <www.cmwf.org>.
PHOTO (COLOR): Only about half of uninsured
children -- who number 8 million -- had a well-child visit in the past
year, new CDC data shows.
~~~~~~~~ By Kim Krisberg
Some items on this website are used by permission granted
in the Fair Use guidelines of the 1976 U.S. Copyright Act.
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