Summary
• This Issue Brief provides historic data through 2004 on the number and percentage of nonelderly individuals with and without health insurance. Based on EBRI estimates from the U.S. Census Bureau’s March 2005 Current Population Survey (CPS), it reflects 2004 data. It also discusses trends in coverage for the 1994–2004 period and highlights characteristics that typically indicate whether an individual is insured.
• Health coverage continues decline: The percentage of the nonelderly population (under age 65) with health insurance coverage declined in 2004 to a post-1994 low of 82.2 percent. Declines in health insurance coverage have been recorded in all but two years since 1994, when 36.5 million nonelderly individuals were uninsured; in 2004, the uninsured population was 45.5 million.
• Employment-based coverage crops: While the percentage of uninsured individuals in the United States did not significantly increase in 2004, fewer workers and their families were covered by employment-based health benefits. The segment of the U.S. population with employment-based health coverage dropped from 64.4 percent in 1994 to 62.4 percent in 2004, though in the years between 1994 and 2000, the percentage of the nonelderly population with employment-based coverage expanded.
• Public program coverage is growing: Public-sector health coverage increased to 17.5 per-cent of the nonelderly population in 2004. Enrollment in Medicaid and the State Children’s Health Insurance Program increased by 1.8 million in 2004, and now covers 13.4 percent of the nonelderly population, which is significantly above the 10.5 percent level of 1999.
• Individual coverage stable: Individually purchased health coverage was unchanged in 2004 and has basically hovered in the high 6 and low 7 percent range since 1994.
• Private- vs. public-coverage trends reversing: Health insurance coverage has generally not sustained unbroken trends since 1994. There were crosscurrents: Employment-based coverage expanded significantly in the 1994–2000 period to exceed the growth in public programs. Subsequently, the dynamic reversed, as public programs expanded while employment-based coverage declined.