Millions of Americans continue to go without health insurance according to a Census Bureau report released in September 2001, approximately 38.7 million Americans 14% of the population lacked health insurance in the year 2000. While that represents a decline for the second straight year in the number of uninsured, in the months since the Census Bureau's report rising unemployment and increased health care costs have contributed to a sharp increase in the number of uninsured. According to estimates by FamiliesUSA, as many as two million people have lost health care coverage since January 2001, increasing the number of uninsured in the country to over 40 million.
More Americans are expected to become uninsured: As outlined in a recent report from the National Coalition on Health Care, A Perfect Storm: The Confluence of Forces Affecting Health Care Coverage, a number of factors make it likely that the country will experience further increases in the number of uninsured Americans in the near future.
Health insurance premiums increased an average of 11 percent in 2000 and 2001, far beyond the rate of inflation. It is estimated that premium increases may be as high as 15 percent in 2002. As a result, some employers - particularly small employers -will 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.
At the same time, if unemployment continues to rise, additional workers can be expected to lose health coverage. While some of those workers may be eligible for the COBRA program, which allows them to purchase health insurance through their former employer, the cost of purchasing COBRA coverage is too prohibitive to be a realistic option for many recently unemployed workers.
These newly unemployed workers, or their children, may also qualify for coverage under Medicaid or the State Children's Health Insurance Program (SCHIP). Unfortunately, most states are currently experiencing severe fiscal crises, and their state budgets are unable to absorb large increases in the number of uninsured. This is particularly true because federal funding for the SCHIP program will decrease temporarily in FY 2003 through 2005, placing additional pressure on state health care budgets.
Who are the uninsured? By and large, it is working Americans or their family members who are without insurance:
- Over 80% of the nonelderly uninsured are from working families 63% 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 85% of them live in households with at least one working adult.
The prospects for Congressional action: Given these factors, there will be some pressure on Congress to take action this year to expand coverage for the uninsured. However, the proposals are likely to be modest we are unlikely to see fundamental change in our health care system this year. There is also disagreement over what form these modest efforts should take. Proposals under consideration include a health insurance tax credit or expanding public health programs, or a bill with elements of both.
Tax credits: The President's proposed FY 2003 budget allocates $89 billion over 10 years to for refundable tax credits to allow low-income households to purchase health coverage in the open market. The maximum dollar value of the credit would be $1,000 for individuals, and $3,000 for families. Individuals with incomes below $15,000 would be eligible for the full credit, which would phase out at $30,000. Families with annual incomes below $30,000 would be eligible for the full amount of the credit, which would phase out at $60,000.
Expanding existing programs: Many in Congress prefer to expand coverage by increasing enrollment in public health programs like Medicaid and SCHIP, and by subsidizing the purchase of COBRA coverage for unemployed workers.
Other legislative proposals: Congress may take action on Medical Savings Accounts; expanded funding for community health centers; restoring access to SCHIP and Medicaid for legal immigrants; and prescription drug coverage under Medicaid.
The Catholic Conference 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 USCCB, through Health and Health Care and A Framework for Comprehensive Health Care Reform, the USCCB has called for action to address the human need for health care.
The USCCB 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 the USCCB and others, has put forward its framework for health care reform, Continuing the Commitment: A Pathway to Heath Care Reform.
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 and adequate health care for all by earmarking resources for health care programs in the fiscal 2003 budget plan.
- Take steps to make sure your community is aware that covering the uninsured remains a serious and growing problem. The Catholic Health Association and 12 other groups have launched a public awareness campaign called Covering the Uninsured. Check out the campaign's website, coveringtheuninsured.org, for more information.
- Contact USCC, 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