Uninsured and Underinsured Frequently Asked Questions
Question: How many people lack health insurance in the United States?
Answer: Both the percentage and number of people without health insurance decreased in 2007. The percentage without health insurance was 15.3 percent in 2007, down from 15.8 percent in 2006, and the number of uninsured was 45.7 million, down from 47.0 million.
The percentage of people covered by private health insurance was 67.5 percent, down from 67.9 percent in 2006. The percentage of people covered by employment-based health insurance decreased to 59.3 in 2007 from 59.7 percent in 2006. The number of people covered by employment-based health insurance, 177.4 million, was not statistically different from 2006.
In 2007, the percentage of children under 18 years old without health insurance was 11.0 percent, lower than it was in 2006—11.7 percent.
Source: Income, Poverty, and Health Insurance Coverage in the United States: 2007, U.S. Census Bureau, 2008.
Question: How many rural Americans are without health insurance?
Answer:
The Chartbook #13: Health Care in Urban and Rural Areas, Combined Years 1998-2000, Agency for Healthcare Research and Quality, Rockville, MD, 2004, has information regarding rural Americans.
In the Chartbook, counties are classified along the urban-rural continuum according to whether they are metropolitan statistical areas (MSAs) and, if not, their proximity to an MSA. A MSA is a large population nucleus with a high degree of economic and social interaction. The categories along the continuum are metro (counties in an MSA), near-metro, near-rural, and rural.
Adequate access to health care services can significantly influence health care use and health outcomes. There has been research that suggests rural residents have less access to health care services than residents of more densely populated areas.
Among the population under 65 years of age, residents of near-rural counties were more likely to be uninsured for an entire year (18.5%) than those living in metro counties (12.7%) or near-metro counties (12.0%).
Question: Who are the rural uninsured?
Answer:
The uninsured in remote rural counties are not a peculiar sub-population of their communities:
- 68 percent come from families where there is at least one full-time worker.
- 30 percent are children.
- Almost two-thirds come from low-income families (less than 200 percent of the federal poverty level - less than $37,700 for a family of four). Families with two full-time workers, married couples, and the employed are also at greater risk of being uninsured if they live in a remote rural county.
Source: Health Care in Rural America: A Series of Features from the Center for Rural Affairs Newsletter, Center for Rural Affairs, 2004.
Question: Does everyone who works have health insurance as part of their employee benefits?
Answer:
No. Health insurance coverage varies based on the type of job and size of the firm. Larger companies, governments, or universities often provide substantial health benefits to their employees at low costs. Small businesses may have a more difficult time providing such health coverage due to the higher expenses associated with insuring fewer people.
Remote rural residents are less likely to be offered health benefits through their employment - Approximately 59 percent of workers in rural non-adjacent counties are offered employer-sponsored health insurance, compared to 69 percent of urban workers, and less than half of workers in rural nonadjacent counties are covered by their employers (compared to nearly 60 percent of urban workers).
Two factors are primarily to blame for the lack of employer-sponsored insurance in rural areas: workers in remote rural counties are more likely to earn low wages and residents of remote rural counties are more likely to work in small businesses. While low-wage workers (below $7/hour) are about three times more likely to be uninsured as other hourly wage earners, working in a small business appears to be the highest predictor of being uninsured in a remote rural area - over two-thirds of uninsured workers in those counties work for a small business with less than 20 employees.
Source: Health Care in Rural America: A Series of Features from the Center for Rural Affairs Newsletter, Center for Rural Affairs, 2004.
Credits
Last revised 11/18/2009
