USCCB - (SDWP) - Health Care: The Uninsured

Health Care: The Uninsured

February 2001

Background

In 1999, for the first time since 1987, the percentage of Americans without health insurance declined: 15.5% of the population had no insurance in 1999, compared to 16.3% in 1998. The strong economy and low unemployment accounts for much of this improvement: between 1998 and 1999, the number of Americans under 65 who had health coverage through an employer increased from 64.9% to 65.8%, continuing an upward trend that began in 1993-94, after falling from a high of 69.2% in 1987.

But 42.6 million Americans – one in six -- were still left with no health insurance in 1999, and that in a time of prosperity and high employment. Over the past ten years, an average of 750,000 people a year have been added to the ranks of the uninsured. In the coming months, we are likely to see several proposals for incremental solutions to the problem of the uninsured. While we should pursue any opportunity that will be a step towards covering more people, the ultimate goal of affordable, accessible health care for all must again become a top priority for our national leaders.

Who are the uninsured? By and large, it is working Americans or their family members who are going without insurance:

82% of the uninsured come from working families; 71% of the uninsured are in families with at least one full-time worker
Among the low-income Americans (income below 200% the federal poverty level) without insurance, 75% come from working families, and nearly 60% are in families with at least one full-time worker
Almost two-thirds of the uninsured are in low-income families
More than 10 million children are uninsured

If the number of uninsured fell in 1999, is there still a problem? YES! Since 1987, the percent of the uninsured had been steadily increasing, even during the prosperous economy of the mid and late 1990s. The decrease in 1999, though welcome, is only a one-year up-tick in a decade-long trend. And a sudden downturn in the economy or increase in health premiums could put us back on the downward trend.

A sharp economic reverse could leave 63 million Americans uninsured by 2005
Even if the numbers of uninsured continue to decline at the 1998-1999 rate, 34 million Americans would go without health insurance in 2005
As premiums increase, and employee contributions go up, fewer workers will be able to afford insurance plans offered at work. One estimate predicts that 12% premium increases in 2000 will cause another 750,000 to become uninsured
Small businesses continue to struggle to offer health insurance to their employees
An increasing number of people are part-time workers, contract-workers, or self-employed, and do not qualify for employer-provided health plans

What are the consequences of being uninsured? People who lack health insurance are far less likely to receive basic health care services.

Studies show they delay seeking care even when in need of medical attention, do not fill prescriptions and have trouble paying medical bills
They are generally in poorer health as a result
While every day thousands of people who lack insurance receive medical care and cannot pay the bill, managed care is making it increasingly difficult for providers to offer "free" care (the cost is shifted to those who can pay) to the uninsured
Many people are under-insured – they have some coverage, but not adequate coverage for their health needs. People lacking adequate health insurance are at risk of having to spend a significant amount of their annual income on medical care

USCC Position

The Church has consistently worked through the years to urge federal and state governments to make sure all Americans have access to affordable, accessible and adequate health care. From the time of the first document issued by what would become the USCC, through Health and Health Care and A Framework for Comprehensive Health Care Reform, USCC has called for action to address the human need for health care.

USCC is working with other Catholic organizations to place the issue of comprehensive health care reform at the top of the national agenda. The Catholic Health Association (CHA), in consultation with USCC and others, has put forward its framework for health care reform, Continuing the Commitment: A Pathway to Heath Care Reform.

Action Requested

It is very unlikely that Congress will undertake a comprehensive health care reform effort this year. However, there will almost certainly be action on various incremental proposals to address the problem of the uninsured. Likely areas of activity include: expanding federally funded insurance coverage for low-income children and their parents, through the State Childrens' Health Insurance Program (SCHIP) or Medicaid; Medical Savings Accounts; expanded funding for community health centers; tax credits or deductions for individuals or for small businesses; and restoring access to SCHIP and Medicaid for legal immigrants. Also, Congress has already begun work on a new Patient's Bill of Rights proposal to protect participants in managed care plans, and on strategies to assist the elderly in paying for prescription drugs.

As one or more of these proposals are put forward in the form of legislation:

Contact USCC, CHA, CCUSA and other community resources to learn about the bills and whether they will truly help more uninsured people gain health coverage
Let your Senators and Representatives know that you expect them to do something to help uninsured Americans, and to start taking steps toward achieving affordable, accessible and adequate health care for all by earmarking resources for health care programs before tax cuts in the fiscal 2002 budget plan

Resources

Documents:
Health and Health Care: A Pastoral Letter of the American Catholic Bishops
A Framework for Comprehensive Health Care Reform
Continuing the Commitment: A Pathway to Heath Care Reform - The Catholic Health Association

Websites:
USCC: usccb.org CHA: chausa.org CCUSA: catholiccharitiesusa.org

For further information: Kathy Curran (ph) 202.541.3188, kcurran@usccb.org, or Mark Gallagher (ph) 202.541.3142, mgallagher@usccb.org