Record Level of Americans Not Insured on Health

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http://www.nytimes.com/2004/08/27/business/27health.html?th

 

August 27, 2004

 

Record Level of Americans Not Insured on Health

By MILT FREUDENHEIM

 

Rising costs for health coverage and a continuing

fall-off in the number of workers in

employer-sponsored health plans are among the reasons

that a greater number of people did not have health

insurance last year, experts say.

 

The increase in uninsured people last year, as

reported by the United States Census Bureau yesterday,

was 1.4 million, to a record 45 million.

 

More than 10 million of those without insurance were

young people, 25 to 34 years old, government officials

said, an increase of 576,000 from 2002. " Young adults

got hammered, " said John F. Holahan, a health

economist at the Urban Institute, a nonprofit research

center in Washington.

 

In 2002, there were 43.6 million people without

insurance, or 15.2 percent of the census estimate of

288.3 million Americans. The proportion of people who

were uninsured grew only slightly last year, to 15.6

percent. That reflected growth in the total population

and 3.2 million more people added to government health

programs including Medicare, Medicaid and state

coverage for children. More than one in four Americans

is in a public program.

 

As the population grew, the number of people who had

insurance also increased, by one million, to 243.3

million last year, also a record, the Census Bureau

said.

 

Health insurance is a hotly debated campaign issue.

Senator John Kerry has promised new subsidies to

extend coverage to more people. The Bush campaign

points to a feature of the new Medicare law that

provides tax breaks for special savings accounts to

help people pay for care.

 

Senator Judd Gregg of New Hampshire, who led a recent

Republican panel that studied health insurance issues,

said the " uptick " in the number of uninsured " reflects

the still sluggish economy " in 2003. He said one

million new jobs had been added since then.

 

Bill Frist of Tennessee, the Senate majority leader,

said the numbers also reflected " a decade-long

downward trend in the proportion of Americans who

receive health insurance through their employers. "

 

Len M. Nichols, vice president of the nonprofit Center

for Studying Health Systems Change in Washington,

said, " The question is whether the recovery will be

strong enough to generate good jobs with health

insurance to counter the fact that health insurance is

more costly now. "

 

Surveys by research groups show that health costs

continue to rise much faster than wages and other

costs borne by employers. Economists say the

employment trend is still moving away from jobs that

provide generous coverage.

 

Employers are already planning for steep increases in

health costs for 2005. A separate survey of 916

employers released yesterday by Mercer Human Resource

Consulting, a benefits consulting firm, said costs of

current coverage would rise about 13 percent next

year. Many employers plan to cut back on benefits and

shift more of the costs to their workers to slow the

increase to 9.6 percent, on average, Mercer said.

 

The cuts will " increase the pressure on small

employers to discontinue coverage or increase their

employees' share of premiums, " said Blaine Bos, a

Mercer survey spokesman. The upshot will be " more

employees saying, 'I don't see the value of that' and

going without insurance, " he said.

 

There were 20.6 million uninsured full-time workers

last year, the Census Bureau said, an increase of 1.6

million over the last two years.

 

The Census Bureau said that 12.1 million people

without insurance were members of families with annual

incomes of $50,000 or more, including 6 million in

families that made at least $75,000 a year. Some

conservative economists contend that these people

could afford to pay for insurance.

 

" Households that earn $50,000 per year or more account

for about 90 percent of the increase in the number of

uninsured over the past 10 years, " according to the

National Center for Policy Analysis, a research center

based in Dallas that says it opposes government

solutions to public policy problems.

 

Health policy experts who advocate a greater

government role say a family with $50,000 in total

income has trouble affording family coverage, which

typically costs more than $9,000 annually, unless it

obtains help from an employer or the government. They

say many of these people are self-employed or work for

small businesses that find health costs daunting.

 

This year the number of uninsured people in families

with incomes of $50,000 or more increased by 704,000,

the census report said. It also said there were

619,000 people without insurance in families with

incomes of less than $25,000.

 

Although a number of states, including Texas, have cut

back on children's health programs, the number of

uninsured children declined slightly, to 8.4 million,

but remained at 11.4 percent of all children, last

year. The proportion of poor children without

insurance was 19.2 percent.

 

The proportion of uninsured people held steady among

Hispanic, Asian and black Americans. About 18.5

percent of blacks, 18.7 percent of Asian-Americans and

32.7 percent of Hispanics did not have insurance.

 

With large numbers of Hispanic residents, Texas and

New Mexico have the highest proportions of uninsured

people, the Census Bureau said. Both had average

uninsured rates of more than 20 percent over the three

years from 2001 to 2003. The three-year average was

19.4 percent in Louisiana, 18.7 percent each in

California and Oklahoma, and 17.8 percent in Alaska.

 

The states with the lowest three-year averages were

Minnesota, at 8.2 percent; Rhode Island, at 9.3

percent; and Iowa and Wisconsin, at 9.5 percent each.

Massachusetts, New Hampshire and Vermont were also at

the low end, with 9.9 percent.

 

The uninsured rate was 15.5 percent in New York, 13.7

percent in New Jersey and 10.4 percent in Connecticut.

 

Copyright 2004 The New York Times Company