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Highlights #13: The Uninsured in America, 1999

Estimates for the Civilian Noninstitutionalized Population under Age 65


Introduction

The uninsured population in the United States is an issue of public policy concern for several reasons. First, health insurance is viewed as necessary to ensure that people have access to medical care and protection against the risk of costly and unforeseen medical events. Timely and reliable estimates of the population’s health insurance status are vital to evaluate the costs and expected impact of public policy interventions to expand coverage or to change the way that private and public insurance is funded. Finally, comparisons of the characteristics of insured and uninsured populations over time give information on whether greater equity has been achieved in insurance coverage or whether serious gaps remain.

Data from the 1999 Medical Expenditure Panel Survey (MEPS) of the Agency for Healthcare Research and Quality show variation in health insurance status among people under 65 according to demographic characteristics such as age, race/ethnicity, sex, and marital status. This report shows the size of the civilian noninstitutionalized population under age 65 that was uninsured throughout the first half of 1999 and identifies groups especially at risk of lacking health insurance. MEPS population estimates for 1999 are not significantly different from 1998 MEPS estimates reported in Rhoades, Brown, and Vistnes, 2000.

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Briefly Stated

  • In the first half of 1999, 15.8 percent of all Americans were uninsured. 
  • Among Americans under 65, 36 percent of Hispanics and 21 percent of blacks were uninsured during the first half of 1999, compared with only 14 percent of whites. 
  • Even though Hispanics represented only 13 percent of the non-elderly U.S. population, they accounted for a fourth (25 percent) of the entire uninsured population. 
  • Young adults ages 19-24 were more at risk of being uninsured than any other age group. Almost a third (32 percent) of young adults were uninsured. 
  •  During the first half of 1999, among people under age 65, those who were separated from their spouse were more likely to be uninsured (33 percent) than people of any other marital status.

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Definition of Uninsured

The uninsured were defined as people not covered by Medicare, TRICARE (Armed-Forces-related coverage), Medicaid, other public hospital/physician programs, or private hospital/physician insurance (including Medigap coverage) from January 1999 through the MEPS interview date. People covered only by noncomprehensive State-specific programs (e.g., Maryland Kidney Disease Program) or private single-service plans (e.g., coverage for dental or vision care only, coverage for accidents or specific diseases) were not considered to be insured.

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Findings

In early 1999, 15.8 percent of all Americans were uninsured and 17.9 percent of Americans under age 65 were uninsured (data not shown). Age plays a key role in whether a person has health insurance. Young adults ages 19-24, 32 percent of whom were uninsured, were the age group most at risk of being uninsured (Figure 1). This group composed 8 percent of the total non- elderly population but 15 percent of the uninsured population (data not shown).

Among people under age 65, minorities were substantially more likely than whites to lack health insurance. Approximately 36 percent of all Hispanics under 65 were uninsured, compared to 21 percent of blacks and 14 percent of whites (Figure 2). Although nearly 70 percent of non-elderly Americans were white, whites accounted for only 55 percent of uninsured people (Figure 3). Among males under age 65 (Figure 4), being uninsured was more likely among Hispanics (38 percent) than among blacks (24 percent) or whites (15 percent). Similarly, among females under 65, being uninsured was more likely among Hispanics (33 percent) than among blacks (18 percent) or whites (13 percent).

People who never married accounted for nearly a quarter (23 percent) of the non-elderly population but over a third (35 percent) of the uninsured population (data not shown). Also, about a third (33 percent) of all people under 65 who were separated were uninsured (Figure 5).

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About MEPS

The Medical Expenditure Panel Survey (MEPS) collects nationally representative data on health care use, expenditures, sources of payment, and insurance coverage for the U.S. civilian noninstitutionalized population. MEPS is cosponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS). This Highlights summarizes data concerning the characteristics of the uninsured population in the United States during the first half of 1999, as derived from the MEPS Household Component, Round 1. For more information about MEPS, see the sources listed on the back page.

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Figures

Figure 1. Percent uninsured by age: People under age 65, first half of 1999
Figure 2. Percent uninsured by race/ethnicity: People under age 65, first half of 1999
Figure 3. Percent distribution of total population and the uninsured by race/ethnicity: People under age 65, first half of 1999
Figure 4. Percent uninsured by race/ethnicity and sex: People under age 65, first half of 1999
Figure 5. Percent uninsured by marital status: People under age 65, first half of 1999

 

Figure 1. Percent uninsured by age: People under age 65, first half of 1999

Figure 1. Percent uninsured by age: People under age 65, first half of 1999

  • Almost a third of young adults ages 19-24 were uninsured.

     DATA SOURCE: 1999 Medical Expenditure Panel Survey Household Component.

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Figure 2. Percent uninsured by race/ethnicity: People under age 65, first half of 1999

Figure 2. Percent uninsured by race/ethnicity: People under age 65, first half of 1999

  • Whites were the least likely to be uninsured.

     DATA SOURCE: 1999 Medical Expenditure Panel Survey Household Component.

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Figure 3. Percent distribution of total population and the uninsured by race/ethnicity: People under age 65, first half of 1999

Figure 3. Percent distribution of total population and the uninsured by race/ethnicity: People under age 65, first half of 1999

  • Hispanics were disproportionately represented among the uninsured.

     DATA SOURCE: 1999 Medical Expenditure Panel Survey Household Component.

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Figure 4. Percent uninsured by race/ethnicity and sex: People under age 65, first half of 1999

Figure 4. Percent uninsured by race/ethnicity and sex: People under age 65, first half of 1999

  • Hispanic males were the most likely to be uninsured.

     DATA SOURCE: 1999 Medical Expenditure Panel Survey Household Component.

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Figure 5. Percent uninsured by marital status: People under age 65, first half of 1999

Figure 5. Percent uninsured by marital status: People under age 65, first half of 1999

  • Married people were the least likely to be uninsured.

     DATA SOURCE: 1999 Medical Expenditure Panel Survey Household Component.

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References    

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-594-1406) or visit the MEPS Web site at: http://www.meps.ahrq.gov/

For a detailed description of the MEPS survey design, sample design, and methods used to reduce sources of nonsampling error, see the following publications:

Cohen J. Design and methods of the Medical Expenditure Panel Survey Household Component. Rockville (MD): Agency for Health Care Policy and Research; 1997. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026.

Cohen S. Sample design of the 1996 Medical Expenditure Panel Survey Household Component. Rockville (MD): Agency for Health Care Policy and Research; 1997. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027.

Estimates of the uninsured for 1998 are shown in:

Rhoades J, Brown E, Vistnes J. Health insurance status of the civilian noninstitutionalized population: 1998. Rockville (MD): Agency for Healthcare Research and Quality; 2000. MEPS Research Findings No. 11. AHRQ Pub. No. 00-0023.

The estimates in this Highlights are based on the following, more detailed publication:

Rhoades J, Chu M. Health insurance status of the civilian noninstitutionalized population: 1999. Rockville (MD): Agency for Healthcare Research and Quality; 2000. MEPS Research Findings No. 14. AHRQ Pub. No. 01-0011.

MEPS Highlights No. 13, AHRQ Pub. No. 01-0023, March 2001, ISSN 1531-5657.

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Suggested Citation:
Highlights #13: The Uninsured in America, 1999. March 2001. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov /data_files/publications/hl13/hl13.shtml