This Issue Brief provides
summary data on the insured and uninsured populations in
the nation and in each state. It discusses the
characteristics most closely related to an individual's
health insurance status. Based on EBRI estimates from the
March 2000 Current Population Survey (CPS), it represents
1999 data—the most recent available.
In 1999, for the first time since
at least 1987, the percentage of Americans with health
insurance increased: 82.5 percent of nonelderly Americans
(under age 65) were covered by some form of health
insurance, up from 81.6 percent in 1998. The percentage
of nonelderly Americans without health insurance coverage
declined from 18.4 percent in 1998 to 17.5 percent in
1999.
The main reason for the decline in
the number of uninsured Americans is the strong economy
and low unemployment. Between 1998 and 1999, the
percentage of nonelderly Americans covered by
employment-based health insurance increased from 64.9
percent to 65.8 percent, continuing a longer-term trend
that started between 1993 and 1994.
In 1999, 34.1 million Americans
received health insurance from public programs, and an
additional 15.8 million purchased it directly from an
insurer. Twenty-five million Americans participated in
the Medicaid program, and 6.5 million received their
health insurance through the Tricare and CHAMPVA programs
and other government programs designed to provide
coverage for retired military members and their families.
Despite expansions in the State
Children's Health Insurance Program (S-CHIP), public
health insurance coverage did not increase overall
between 1998 and 1999. The percentage of nonelderly
Americans covered by Medicaid and other
government-sponsored health insurance coverage did not
change between 1998 and 1999, though some children
benefited from expansions in government-funded programs.
The percentage of children in families just above the
poverty level without health insurance coverage declined
dramatically, from 27.2 percent uninsured in 1998 to 19.7
percent uninsured in 1999. Some of the decline can be
attributed to expansions in Medicaid and S-CHIP, but it
appears that expansions in employment-based health
insurance and individually purchased coverage had an even
larger effect than expansion of S-CHIP.
Even though the number and
percentage of uninsured declined substantially between
1998 and 1999, more than 42 million Americans remain
uninsured. As long as the economy is strong and
unemployment is low, employment-based health insurance
coverage will expand and the uninsured will decline
gradually. If the economy continues to soften or comes
close to a recession, the number of uninsured would
easily and quickly start to increase again as
unemployment rises. Should a severe downturn in the
economy occur, causing the uninsured to represent 25
percent of the nonelderly population, 63 million
Americans would be uninsured.
