The Working Uninsured: Who They are, How They Have Changed, and the Consequences of Being Uninsured, with Presidential Candidate Proposals Outlined

Abstract

This paper presents data on workers who do not have health insurance. It offers a description of this population, discusses how the population has changed over time, and reviews the consequences of being uninsured for health care. Also included is a description of the 2000 presidential candidates' proposals to reduce the number of uninsured Americans.

Using data from the 1988-1999 March supplements to the U.S. Census Bureau's Current Population Survey, the author finds that the percentage of workers without any form of health insurance has been increasing since at least 1987, with most of the increase occurring prior to 1993. In 1998, uninsured adult workers made up 56 percent of the uninsured population. In all, over 80 percent of the 43.9 million uninsured Americans in 1998 were in a family with a working family head. The working uninsured are heavily concentrated in certain segments of the population, and the likelihood of being uninsured increased substantially for certain groups of workers between 1987 and 1998. Data from the 1996 Medical Expenditure Panel Survey (MEPS) indicate that health insurance makes a difference in health status and access to health care services, with uninsured workers more likely than insured workers to report that their health status is fair or poor, more likely to receive health care in a hospital or emergency room, and less likely to receive care in an office-based setting.

In the 2000 presidential campaign, both major-party candidates, Vice President Al Gore and Texas Gov. George W. Bush, put forth proposals to reduce the number of uninsured Americans. Both proposals were based on incremental strategies and were found unlikely to have a substantial impact on the number of the uninsured.

Keywords: Employment-based benefits, Health insurance coverage, Uninsured, Health care attitudes and opinions, Health care utilization, Health care policy

JEL Classification: I1, J3