EBRI Issue Brief

Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2006 Current Population Survey

Oct 3, 2006 32  pages


NOTE: Census Bureau 2007 Data Update — On March 23, 2007, six months after this October 2006 EBRI Issue Brief was published, the U.S. Census Bureau issued new data revising its 2004 and 2005 health insurance coverage estimates, reducing the estimated number of Americans without health insurance by nearly 2 million people. The bureau said the inflated numbers were due to a 12-year-old computer programming error. The revised estimates show that 44.8 million people (or 15.3 percent of the population) were without health insurance in 2005; the original estimate was 46.6 million (or about 15.9 percent of the population). For the Census Bureau’s Web site and press release about the update, click here

• This Issue Brief provides historic data through 2005 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 2006 Current Population Survey (CPS), it reflects 2005 data. It also discusses trends in coverage for the 1994–2005 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 2005 to a post-1994 low of 82.1 percent. Declines in health insurance coverage have been recorded in all but three years since 1994, when 36.5 million nonelderly individuals were uninsured. The percentage of nonelderly individuals without health insurance coverage was 17.9 percent in 2005, up slightly from 17.6 percent in 2004.

Employment-Based Coverage Remains Dominant Source of Health Coverage: The segment of the U.S. population with employment-based health coverage dropped from 64.4 percent in 1994 to 62.0 percent in 2005, though in the years between 1994 and 2000, the percentage of the nonelderly population with employment-based coverage expanded. Employment-based health benefits remain by far the most common form of health coverage in the United States.

Public Program Coverage Is Stable: Public-sector health coverage was unchanged as a percentage of the population in 2005, accounting for 17.7 percent of the nonelderly population. Enrollment in Medicaid and the State Children’s Health Insurance Program remained at 34.7 million in 2005, and covers 13.5 percent of the nonelderly population, which is significantly above the 10.5 percent level of 1999 but not much above the 12.7 percent level of 1994.

Individual Coverage Stable: Individually purchased health coverage was unchanged in 2005 and has basically hovered in the high 6 percent 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. 2005 may be the beginning of new trend that could take the form of erosion in employment-based coverage that is not offset by expansions in public programs, thus leading to long-term growth in the uninsured.