Trends and Indicators in the Changing Health Care Marketplace Section 7: Implications of Health Market Trends for Consumers and the Safety Net
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Trends and Indicators in the Changing Health Care Marketplace
Exhibit 7.1: Number of the Nonelderly Uninsured, 1994-2004
The number of the nonelderly (under age 65) uninsured in the United States increased in 2004 to 45.5 million, an increase of 800,000 over 2003. Health insurance affects people’s access to health care, their health status, their job decisions, and their financial security. Health insurance makes a difference in whether people get necessary medical care, where they get their care, and, ultimately, how healthy they are. About two-thirds of the nonelderly uninsured are low income (see Exhibit 7.4), so medical bills can cause financial burdens for individuals and families. Uncompensated care to uninsured and underinsured individuals and the safety net of public hospitals and community clinics do not fully substitute for health insurance.
Notes: Changes in the Current Population Survey’s (CPS) sample and questionnaire have been made over the years, which hamper the ability to trend data across years. Health insurance estimates for 1999 and later years that use the revised questionnaire cannot be compared with CPS estimates from earlier years. *Revised method estimates for 1999 shown in this exhibit are comparable to later years, except they are based on a smaller sample.
Source: Kaiser Family Foundation, Health Insurance Coverage in America, 2004 Data Update, November 2005, Figure 1, p.9, at http://www.kff.org/uninsured/7415.cfm prepared by the Kaiser Commission on Medicaid and the Uninsured, and the Urban Institute using data from the Census Bureau’s March Supplements to the Current Population Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 03/15/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 7.2: Changes in Health Insurance Coverage Rates, Children and Nonelderly Adults, (Percentage Point Differences), 2002-2003
From 2002 to 2003, employer coverage of both children and adults declined, with a greater decline for children than for nonelderly adults. Increases in Medicaid coverage helped to offset the losses in employer coverage for children, but only partially offset such losses for nonelderly adults.
Notes: Medicaid/Other Public also includes the State Children’s Health Insurance Program, other state programs, Medicare, and military-related coverage.
Source: Kaiser Family Foundation, Health Insurance Coverage in America, 2003 Data Update, November 2004, Figure 22, Table 2 and Table 3, at http://www.kff.org/uninsured/7153.cfm, prepared by the Kaiser Commission on Medicaid and the Uninsured, and the Urban Institute using data from the Census Bureau’s March 2004 Supplement to the Current Population Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 02/02/05
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 7.3: Health Insurance Coverage of the Nonelderly by Poverty Level, 2004
As income decreases, the likelihood of being uninsured increases (18.3% of those with moderate incomes vs. 36.5% of the poor were uninsured in 2004) and the likelihood of having employer-sponsored coverage decreases (65.9% of those with moderate incomes vs. 15.0% of the poor had such coverage in 2004). Because the Near Poor are less likely to qualify for public insurance and have decreased access to employer-sponsored insurance, almost a third (28.5%) of this group was uninsured in 2004.
Notes: Percentages may not total 100% due to rounding. The federal poverty level was $19,307 for a family of four in 2004. Medicaid also includes the State Children’s Health Insurance Program (SCHIP). Other Public includes Medicare, military-related coverage, and state programs other than Medicaid and SCHIP.
Source: Kaiser Family Foundation, Health Insurance Coverage in America, 2004 Data Update, November 2005, Table 1, p. 26, at http://www.kff.org/uninsured/7415.cfm, supplemented with data prepared by the Kaiser Commission on Medicaid and the Uninsured, and the Urban Institute using data from the Census Bureau’s March 2005 Supplement to the Current Population Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 03/15/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 7.4: The Nonelderly Uninsured by Poverty Level, 2004
In 2004, almost two-thirds (64.3%) of the uninsured were from families with incomes below 200% of the federal poverty level (or FPL, which was $19,307 for a family of four in 2004). More than one-third (36.8%) of the uninsured had incomes below poverty, and an additional 27.5% had incomes below twice poverty.
Notes: The federal poverty level was defined as $19,307 for a family of four in 2004.
Source: Kaiser Family Foundation, Health Insurance Coverage in America, 2004 Data Update, November 2005, Table 10, p. 36, at http://www.kff.org/uninsured/7415.cfm, prepared by the Kaiser Commission on Medicaid and the Uninsured, and the Urban Institute using data from the Census Bureau’s March 2005 Supplement to the Current Population Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 03/15/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 7.5: Health Status Within Health Insurance Coverage Types, 2004
The uninsured are more likely than those with employer or other private coverage to be in fair or poor health (9% vs. 5% in 2004). The Medicaid population is the least healthy, with one in five (20%) being in fair or poor health.
Notes: Medicaid also includes the State Children’s Health Insurance Program, other state programs, Medicare, and military-related coverage. May not total 100% due to rounding.
Source: Kaiser Family Foundation, Health Insurance Coverage in America, 2004 Data Update, November 2005, Figure 18, p. 18, at http://www.kff.org/uninsured/7415.cfm, prepared by the Kaiser Commission on Medicaid and the Uninsured, and the Urban Institute using data from the Census Bureau’s March 2005 Supplement to the Current Population Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 03/15/06
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 7.6: Barriers to Health Care by Insurance Status, 2003
Lacking insurance has serious consequences for the uninsured. Without insurance, the cost of care becomes a barrier preventing the uninsured from obtaining recommended health care services and treatment. Nearly half (47%) of the uninsured reported in 2003 that they postponed seeking care because of costs, and about a third did not fill a prescription (37%) or skipped recommended treatment (35%) because of cost. The uninsured were 3-4 times more likely than the insured to say they had experienced these problems.
Notes: Insured includes those covered by public or private health insurance. *Experienced by the respondent or a member of their family.
Source: Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured, Access to Care for the Uninsured: An Update, September 2003, Chart 2, p. 3, at http://www.kff.org/uninsured/4142.cfm, using unpublished data from the Kaiser 2003 Health Insurance Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 4/01/04
Trends and Indicators in the Changing Health Care Marketplace
Exhibit 7.7: Consequences of Not Getting Care, by Insurance Status, 2003
Both the uninsured and insured experience serious consequences when they don’t get medical care. In 2003, about half reported that they suffered painful temporary disability (57% uninsured, 52% insured) or loss of time at important activities (50% uninsured, 42% insured). About one-fifth suffered a long-term disability (19% uninsured, 15% insured).
Notes: No significant difference between groups for any of these measures. Insured includes those covered by public or private health insurance. *Experienced by the respondent or a member of their family.
Source: Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured, Access to Care for the Uninsured: An Update, September 2003, Chart 3, p. 4, at http://www.kff.org/uninsured/4142.cfm, using unpublished data from the Kaiser 2003 Health Insurance Survey.
Trends and Indicators in the Changing Health Care Marketplace Information provided by the Health Care Marketplace Project. Publication Number:7031 Information Updated: 4/01/04
