Health Care for the Uninsured

February, 2004


Issue

Millions of Americans continue to go without health care coverage. Over 43 million Americans – 15.2% of the population -- were uninsured in 2002, an increase of 2.4 million from the year before and the largest annual increase since 1992. The increase is due in large part to the drop in those covered by employer-based plans. The picture is even worse for people in more vulnerable communities: 19% of African-Americans, 32.4% of Hispanics, and 33% of immigrants do not have health insurance.

Background

More Americans may become uninsured: The strong economy and low unemployment rates of the 1990s helped more Americans gain health insurance coverage. But the weak economy, increasing joblessness, and rising health care costs have reversed that movement. If those conditions continue or worsen, the ranks of the uninsured will swell. Some projections suggest that, given current economic trends, the number of uninsured could reach 50 million by 2006.

Health insurance premiums paid by employers increased an average of 11% in 2001, 12.7% in 2002, and 13.9% in 2003, far beyond the rate of inflation. With estimates of increases as high as 15 percent in 2004, we could be facing annual double-digit increases for the foreseeable future. If that occurs, some employers - particularly small employers - could discontinue providing health insurance coverage to their workers entirely, while others will pass the increased costs on to their employees, causing many workers to forgo coverage. In addition, the percentage of firms offering retiree coverage has declined substantially over time.

While uninsured families may qualify for coverage under Medicaid or the State Children's Health Insurance Program (SCHIP), most states are currently experiencing severe fiscal crises, and their state Medicaid budgets are unable to absorb large increases in the number of uninsured. Over a million people have lost coverage under these programs as a result of state budget cuts during the past two years.

Who are the uninsured? By and large, it is working Americans or their family members.

  • 8 out 10 of the nonelderly uninsured are from working families – 70 % are in families with at least one full-time worker - and more than one-half are in low-wage families with incomes below 200% of the federal poverty level.
  • More than 8 million children are uninsured - and more than 80% of them live in households headed by a working adult.
What are the consequences of being uninsured or underinsured? People who lack health insurance are far less likely to receive basic health care services, and are generally in poorer health as a result. They may delay seeking needed medical care and filling prescriptions, or have trouble paying medical bills while meeting other essential needs such as food, housing and utilities. The uninsured receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less care. Babies whose mothers are low-income and uninsured are 60% more likely to die in infancy. The Institute of Medicine estimates that 18,000 Americans die unnecessarily each year due to the lack of health insurance coverage.

The prospects for Congressional action: Affordable and accessible heath care will be a topic of significant national attention this year. The continued rise in the number of uninsured, rising heath care costs and the presidential election will push health care to the top of the agenda for discussion. Senate Majority Leader Bill Frist has stated that he wants to work on ways to cover the uninsured this year and has appointed a Senate Task Force on the issue headed by Sen. Judd Gregg. All of the major Democratic presidential candidate have health care proposals. However, it is unlikely that legislation to help significant numbers of the uninsured will become law this year.

Among the kinds of proposals likely to be discussed this year are: tax credits for individuals to buy their own health coverage in the open market or through state sponsored purchasing agreements; incentive to participate in health savings accounts tied to high deductible insurance; expanding existing federal health programs such as Medicaid and SCHIP; expanding funding for community health centers; and restoring access to SCHIP and Medicaid for legal immigrants.

Our Position

The USCCB has consistently worked for access to affordable health care for all that reflects these principles: Respect for Life; Priority Concern for the Poor; Universal Access; Comprehensive Benefits; Pluralism; Quality; Cost Control; and Equitable Financing. (See USCCB statements Health and Health Care and A Framework for Comprehensive Health Care Reform).

The Catholic Health Association (CHA), in consultation with the USCCB and others, has put forward its framework for health care reform, Continuing the Commitment: A Pathway to Heath Care Reform in April 2000.

A subcommittee of the bishops’ Domestic Policy Committee, which includes leaders from CHA and Catholic Charities USA, is working on a reiteration of the principles for health care reform in today’s context, and to help coordinate a united Catholic effort on the issue of health care for all.

What You Can Do

  • Contact your Senators and Representatives and urge them to take action to help uninsured Americans, and to start taking steps toward achieving affordable, accessible health care for all by insisting on resources for health care programs in the fiscal 2005 budget plan.
  • Take steps to make sure your community is aware that covering the uninsured remains a serious and growing problem. The USCCB and the Catholic Health Association of the United States are participating in a public awareness campaign called Cover the Uninsured Week. The week-long series of events from May 10-16, 2004 is intended to increase awareness of the crisis of the uninsured. Check out the USCCB and CHA websites for more information on how to participate in your area.
  • Contact USCCB, CHA, CCUSA and other community resources to learn about what bills are active in Congress and whether they will truly help more uninsured people gain health coverage

For More Information

USCCB: Kathy Curran, 202-541-3188, kcurran@usccb.org; www.usccb.org


CCUSA: Lisa Smith, 703-549-1390, x160, lsmith@catholiccharitiesusa.org; www.catholiccharitiesusa.org
CHA: Peggy Crowley or Alyssa Keefe, 202-296-3993, pcrowley@chausa.org, akeefe@chausa.org; www.chausa.org

Email us at sdwpmail@usccb.org
Social Development and World Peace | 3211 4th Street, N.E., Washington DC 20017-1194 | (202) 541-3180 © USCCB. All rights reserved.





Email us at JPHDmail@usccb.org
Justice, Peace and Human Development | 3211 4th Street, N.E., Washington DC 20017-1194 | (202) 541-3180 © USCCB. All rights reserved.