This Issue Brief provides historic data through 2002 on the number and percentage of nonelderly Americans with and without health insurance. It discusses trends in coverage for the 1987-2002 period and highlights characteristics that typically indicate whether an individual is insured. Based on EBRI estimates from the U.S. Census Bureau's March 2003 Current Population Survey (CPS), it represents 2002 data.
The percentage of the nonelderly American population (under age 65) with health insurance coverage declined in 2002 to a post-1987 low of 82.7 percent. Declines in health insurance coverage have been recorded in all but three years since 1987, when 29.5 million nonelderly Americans were uninsured; in 2002, the uninsured population was 43.3 million.
The main reason for the increase in the number of uninsured Americans in 2002 was the weak economy coupled with the rising cost of providing health benefits. Fewer workers and their families were covered by employment-based health benefits. The segment of the American population with employment-based health coverage dropped from 70.1 percent in 1987 to 64.2 percent in 2002. In 2001 and 2002, both the number and percentage of Americans covered by health insurance declined.
The largest public program, state-administered Medicaid, increased enrollment by 1.6 million from 2001 to 2002, to cover 11.9 percent of the nonelderly population. That figure is significantly above the 8.7 percent level in 1987 but below the high of 12.9 percent in 1993.
Public-sector health coverage increased to 15.9 percent of the nonelderly population in 2002, and remains above the pre-1990 low of 13.3 percent.
Individually purchased health coverage rose slightly, from 6.6 percent in 2001 to 6.7 percent in 2002, yet remains less popular than it was in 1987. This type of health insurance coverage recorded a high of 7.7 percent in 1993. The number of people with such coverage rose from 15 million in 1987 to 16.8 million in 2002.
No type of health insurance coverage has recorded an unbroken trend since 1987. There were crosscurrents: Employment-based coverage declined significantly enough in the 1987-1993 period to overwhelm growth in public programs. In the next six years, the dynamic reversed, as public programs declined more quickly than growth in employment-based coverage. Public programs declined as the poverty population dropped during an economic boom that pulled the poor into the work force while welfare reform pushed them in the same direction.
