Highlights #4: Health Insurance Coverage in America, 1996
Estimates for the U.S. Civilian Noninstitutionalized
Population
Introduction
Compared to people without health care
coverage, insured people are more likely to have a regular source
of medical care and to spend less out of pocket on health services.
Moreover, insured and uninsured people experience different treatment
patterns, quality, and continuity in their health care. Medical
Expenditure Panel Survey (MEPS) data show that 83 percent of
Americans, 218.8 million people, had some type of private or
public insurance coverage during the first half of 1996. Roughly
68 percent had private health insurance, while approximately
15 percent were covered only by Medicare, Medicaid, or other
public sources. The remaining 17 percent of the population were
uninsured. Nearly 61 percent of the population had job-related
coverage. Coverage through the workplace represented more than
89 percent of all private insurance. This Highlights describes
the distribution of health insurance according to demographic
characteristics such as age and race/ethnicity.
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Briefly
Stated
- the first half of 1996, 83 percent of Americans, 218.8 million people, had some type of private or public health insurance coverage. About 68 percent had private health insurance; 15 percent were covered only by Medicare, Medicaid, or other public sources; and the remaining 17 percent were uninsured.
- 61 percent of the population had job-related coverage. Employment-based coverage represented more than 89 percent of all private insurance.
- 69 percent of people under 65 years of age were covered by private insurance, 12 percent were covered by public insurance, and 19 percent were uninsured.
- at high risk of being uninsured included racial/ethnic minorities (particularly Hispanic males), young adults ages 19-24, and people under 65 who were in good or fair health.
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MEPS
Definitions of Private and Public Insurance
Private health insurance is defined as insurance
that provides coverage for hospital and physician care. Insurance
that provides coverage for a single service only, such as dental
or vision coverage, is not counted as private insurance.
Individuals are
considered to have public insurance if they have coverage only
under Medicare, Medicaid,
CHAMPUS/CHAMPVA (Civilian Health and Medical Programs for the
Uniformed Services and Veterans' Affairs), or some other type
of public hospital and physician coverage.
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Age
Of persons under 65 years of age, 69 percent
had private insurance coverage, 12 percent had public coverage,
and 19 percent were uninsured.
In general, children under age 18 are more
likely than adults to be insured. Public insurance plays a key
role in insuring low-income children. One in four children under
age 4, nearly the same proportion ages 4-6, and one in five children
ages 7-12 obtained public coverage, usually through Medicaid.
Despite the existence of the Medicaid safety net, however, 11
million children lacked health insurance coverage.
Young adults ages 19-24 had the highest risk
of being uninsured (Figure 1). Over
a third of them (38 percent) were uninsured, more than twice
the rate for all Americans. Two partial explanations of the low
rate of insurance among this age group are the fact that young
adults who are not full-time students are likely to lose dependent
coverage on their parents' plans and the tendency of young people
to be employed in transitory or low-wage jobs that do not offer
health insurance coverage. Although they comprised less than
a tenth of the non-elderly population, young adults represented
nearly a fifth of the uninsured population. They also had the
lowest rates of private insurance coverage.
MEPS data also show that, although 6 out of
10 elderly Americans were covered by private insurance (almost
always in addition to Medicare), nearly 4 out of 10 were covered
only by public insurance (Medicare only or Medicare in conjunction
with Medicaid or another public source).
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Race/Ethnicity
Figure 2 shows that
no more than half of all Hispanic and black Americans under age
65 (45 and 50 percent, respectively) were covered by private
health insurance, compared to more than three-quarters of whites
(77 percent). Hispanic and black Americans were more than twice
as likely as white Americans to be covered by public health insurance,
although they also were more likely to be uninsured.
Young adults ages 19-24 were the non-elderly
age group most at risk of lacking private insurance and of being
uninsured. There are also striking disparities in health insurance
coverage when racial/ethnic background is considered. Half of
all Hispanic and black young adults were uninsured (53 percent
and 50 percent, respectively) compared to 31 percent of white
young adults. In addition, white young adults were significantly
more likely to obtain private insurance and less likely to rely
on public insurance than their Hispanic and black counterparts.
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Health
Status
Non-elderly
persons in fair or poor health were less likely than those
in better health to have private insurance (Figure
3). However, public insurance helped reduce the health-related
disparities in private coverage. Nearly 25 percent of persons
in fair health and almost 40 percent of persons in poor health
obtained public coverage.
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About
MEPS
The
Medical Expenditure Panel Survey (MEPS) collects nationally
representative data on health care use, expenditures, source
of payment, and insurance coverage for the U.S. civilian noninstitutionalized
population. MEPS is cosponsored by the Agency for Health Care
Policy and Research and the National Center for Health Statistics.
This Highlights summarizes data concerning the distribution
of insurance coverage in the United States during the first
half of 1996, 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.
Risk of being uninsured by age: First half of 1996
Young adults ages 19-24
were the age group most likely to lack health insurance. Over
a third of young adults were uninsured, more than twice the rate
for all Americans.
DATA SOURCE: 1996 Medical
Expenditure Panel Survey Household Component, Round 1.
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Figure 2. Race/ethnicity
and health insurance status: First half of 1996
Hispanic and black Americans
were less likely than white Americans to be privately insured,
but they were more likely to have public insurance.
DATA SOURCE: 1996 Medical Expenditure
Panel Survey Household Component, Round 1.
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Figure 3. Perceived
health status and health insurance status of the population
under age 65: First half of 1996
The proportion of persons without any insurance
did not vary greatly among health status groups because those
in poorer health were more likely to be covered by public insurance. 
- Hispanics were disproportionately represented among the uninsured.
DATA SOURCE: 1996 Medical Expenditure Panel Survey
Household Component, Round 1.
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References
For more information on MEPS, call the MEPS
information coordinator at AHRQ (301/594-1406) or visit the MEPS
section of the AHRQ Web site at http://www.ahrq.gov/
For a detailed description of the MEPS survey
design, sample design, and methods used to minimize 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. AHRQ 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. AHRQ Pub. No. 97-0027.
The estimates in this Highlights are based
on the following, more detailed publication:
Vistnes JP, Monheit AC. Health insurance status
of the civilian noninstitutionalized population: 1996. Rockville
(MD): Agency for Health Care Policy and Research; 1997. MEPS
Research Findings No. 1. AHRQ Pub. No. 97-0030.
These publications are available from the
AHRQ Clearinghouse (800/358-9295) and through the AHRQ Web site.
MEPS Highlights
No.4, AHRQ Pub. No. 98-0031, May 1998.
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Suggested Citation:
Highlights #4: Health Insurance Coverage in America, 1996. May 1998. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/data_files/publications/hl4/hl4.shtml |
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