This Issue Brief/Special Report
examines the extent of health insurance coverage in the
United States, the characteristics of the uninsured
population by employment status, firm size, industry,
income, location, family type, gender and age, race and
origin, and education, as well as how the uninsured
population has changed over the last several years.
Eighty-three percent of nonelderly
Americans and 99 percent of elderly Americans (aged 65
and over) were covered by either public or private health
insurance in 1992, according to EBRI tabulations of the
March 1993 Current Population Survey (CPS). The March
1993 CPS is the most recent data available on the number
and characteristics of uninsured Americans.
In 1992, 17.4 percent of the
nonelderly population—or 38.5 million people—were not
covered by private health insurance and did not receive
publicly financed health assistance. This compares with
36.3 million in 1991 (16.6 percent), 35.7 million in 1990
(16.5 percent), 34.4 million in 1989 (16.1 percent), and
33.6 million in 1988 (15.9 percent).
The most important determinant of
health insurance coverage is employment. Nearly
two-thirds of the nonelderly (62.5 percent) have
employment-based coverage. Workers were much more likely
to be covered by employment-based health plans than
nonworkers (71 percent, compared with 40 percent).
A primary reason for the increase
in the number of uninsured between 1991 and 1992 is a
decline in employment-based coverage among individuals
(and their families) working for small firms. Forty-two
percent of the additional 2.2 million individuals without
coverage between 1991 and 1992 were in families in which
the family head worked for an employer with fewer than 25
employees.
The number of children who were
uninsured in 1992 was 9.8 million, or 14.8 percent of all
children. This compares with 9.5 million and 14.7 percent
in 1991. The increase in the number and proportion of
uninsured children was partially offset by an increase in
the proportion of children with Medicaid.
In 12 states and the District of
Columbia, more than 20 percent of the population was
uninsured in 1992 (table 3). These states and their
uninsured rates were Nevada (26.6 percent), Oklahoma
(25.8 percent), Louisiana (25.7 percent), Texas (25.7
percent), the District of Columbia (25.5 percent),
Florida (24.2 percent), Arkansas (23.5 percent),
Mississippi (22.7 percent), New Mexico (22.5 percent),
Georgia (22.4 percent), California (22.2 percent), South
Carolina (20.8 percent) and Alabama (20.1 percent).
