This Issue Brief presents
data on workers who do not have health insurance. It
offers a description of this population, discusses how
this population has changed over time, and reviews the
consequences of being uninsured. Also included is a
description of the 2000 presidential candidates'
proposals to reduce the number of uninsured Americans.
The percentage of workers without
any form of health insurance has been increasing since at
least 1987. In 1998, 18.1 percent of workers were
uninsured, up from 14.6 percent in 1987, although most of
the increase occurred prior to 1993.
Uninsured adult workers made up 56
percent of the uninsured population in 1998. In all, 83.2
percent of the 43.9 million uninsured Americans were in a
family with a working family head.
The working uninsured are heavily
concentrated in certain segments of the population. In
1998, 53 percent of uninsured workers were under age 35,
58 percent were male, 57 percent were white, nearly 90
percent had not received a college diploma, 78 percent
worked full time, 20 percent worked in the service
industry, 60 percent were employed in small firms or were
self-employed, 42 percent earned $7.00 or less per hour,
and 99 percent earned less than $50,000 per year.
The likelihood of being uninsured
increased substantially for certain groups of workers
between 1987 and 1998. The highest rates of increase were
found among workers ages 55–64 (44 percent), in
families at or above 400 percent of the federal poverty
level (61 percent), in the public sector (34 percent), in
the largest firms (53 percent), with hourly wages of
$15.00 or more (50 percent), with annual income between
$25,000 and $75,000 (100 percent), and with retirement
plans (112 percent).
Health insurance makes a difference
in health status and access to health care services. Data
show that uninsured workers are more likely than insured
workers to report that their health status is fair or
poor. Compared with insured workers, uninsured workers
were more likely to receive health care in a hospital or
emergency room, and were less likely to receive it in an
office-based setting.
Both the major-party presidential
candidates, Vice President Al Gore and Texas Gov. George
W. Bush, have put forth proposals to reduce the number of
uninsured Americans. While both candidates' proposals
recognize that the bulk of uninsured Americans are either
children or workers employed by small firms, the proposed
strategies to deal with these populations are
incremental, and are unlikely to have a substantial
impact on the number of uninsured Americans.
