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STATISTICAL BRIEF #39:
The Uninsured in America, First Half of 2002: Estimates of the Uninsured Living in Working Families for the Civilian Noninstitutionalized Population under Age 65
Highlights
- In the first half of 2002, 20.9 percent of adults age 19-64 and 13.3 percent of children age 0-18 were uninsured in the United States.
- Among those uninsured, 78.4 percent lived in a working family (a family in which at least one adult was employed).
- Most uninsured Americans lived in a working family with at least one adult full-time worker: 60.0 percent of uninsured adults and 74.7 percent of uninsured children.
- 9.7 percent of uninsured adults and 17.7 percent of uninsured children lived in a working family with two or more adult full-time workers.
- 14.0 percent of uninsured Americans lived in a working family with only part-time workers.
- From a different perspective, 32.1 percent of all persons living in a family with only part-time workers were uninsured while only 15 percent of persons living in a family with at least one full-time worker were uninsured. Those living in a family with two full-time workers were the least likely to be uninsured, at 4.5 percent.
Introduction
Health insurance coverage for Americans under age 65 is closely linked with employment, income, and family characteristics. Private group coverage is primarily obtained through and subsidized by employers. Public insurance is primarily available to persons with disabilities and to children, and sometimes their parents, in families with incomes that range from 0 percent to between 133 percent and 200 percent of the Federal poverty line. Those without employer-sponsored or public coverage face high prices in the nongroup private insurance market.
In recent years health care costs have risen, leading many employers to respond by either dropping insurance coverage for their workers or passing some of the costs onto their employees in the form of higher premium shares, higher deductibles, and less generous benefits.*
This Statistical Brief presents data from the Household Component of the Medical Expenditure Panel Survey (MEPS-HC) for the first half of 2002 on the percentage and number of uninsured Americans under the age of 65 who lived in families with an adult worker. Estimates are presented for four types of working families: 1) those with any employed adult, 2) those with at least one full-time working adult, 3) those with only part-time working adults, and 4) those with two or more full-time working adults. Note that these four types of families may overlap; for example, number 4 is a subset of number 2. All differences between estimates discussed in the text are statistically significant at the 0.05 level.
Findings
In the first part of 2002, 18.5 percent of the U.S. civilian noninstitutionalized population under the age of 65 was uninsured (figure 1) for a total of 45.9 million individuals (not shown). Children (age 18 and under) were less likely than adults (over age 18) to be uninsured (13.3 percent versus 20.9 percent). Of the 45.9 million uninsured in the U.S., 10.2 million were children and 35.7 million were adults (not shown).
A large percentage of America's uninsured, 78.4 percent, lived in working families (figure 2). This represents 36.0 million uninsured Americans in the first part of 2002 (not shown). A higher percentage of uninsured children (84.5 percent) lived in a family with at least one adult employed than uninsured adults (76.6 percent).
Full-time vs. part-time work status can have an impact on employer-sponsored coverage because employers often provide insurance coverage only to full-time workers or require part-time workers to pay a larger share of premiums than full-time workers.
Figure 2 shows that a large percentage of the uninsured population under age 65, 63.3 percent, lived in a family with at least one full-time working adult (29.0 million--not shown). This accounts for 74.7 percent of uninsured children and 60.0 percent of uninsured adults. Furthermore, 17.7 percent of uninsured children (1.8 million--not shown) and 9.7 percent of uninsured adults (3.5 million--not shown) lived in families where there were two or more full-time working adults. A smaller percentage of uninsured individuals lived in working families that were supported by only part-time working adults (14.0 percent): 5.5 million uninsured adults (15.4 percent) lived in a family with no full-time workers, while only 0.9 million children (8.8 percent) lived in such a family.
Figure 3 shows the percentage of all persons under age 65 living in different types of working families who were uninsured. Those living in a family with only part-time workers were more likely to be uninsured than persons living in a family with at least one full-time worker: 32.1 percent and 15.0 percent, respectively. Those living in families with two full-time workers were the least likely to be uninsured, at only 4.5 percent.
Data Source
The estimates provided in this brief come from the 2002 MEPS-HC file (HC-053) with point-in-time estimates for the early part of 2002 for Panel 6, Round 3, and Panel 7, Round 1 persons. HC-053 contains data on employment, health insurance, health status, and demographic characteristics of both individuals and households for the first part of 2002.
Definitions
Age
Adults are ages 19 to 64. Children are ages 18 and under. Note that some other MEPS Statistical Briefs use different age ranges for children and adults and will report slightly different estimates for the uninsured. For example, Statistical Brief #19 (Rhoades) reports uninsurance among children ages 0-17 at 12.9 percent for the first part of 2002.
Insured
Insurance status is measured over the current round of the survey; in this file (HC-053) the round took place in the first part of 2002. Persons are defined as insured if they held one of the following types of coverage during the round: private insurance, Medicare, TRICARE, Medicaid, SCHIP (State Children's Health Insurance Program), or other public hospital/physician coverage.
Uninsured
Persons not insured by private insurance, Medicare, TRICARE, Medicaid, SCHIP (State Children's Health Insurance Program), or other public hospital/physician coverage at any point during the round are defined as uninsured.
Employed
Persons currently employed or who had a job in the first part of 2002 are defined as being employed at the time of the survey. Persons with a job in the first part of 2002 are included because insurance status is measured over the round.
Full-Time Worker
A full-time worker is defined as a person who works 35 hours or more per week at his or her current main job.
Part-Time Worker
A part-time worker is defined as a person who works less than 35 hours per week at his or her current main job.
Family
Families are constructed to include adults and those family members who would typically be eligible for coverage under the adults' private health insurance family plans, a grouping otherwise known as Health Insurance Eligibility Units (HIEUs). These families comprise adults, their spouses, and their unmarried natural/adoptive children age 18 and under. Children under age 24 who are full-time students are also included in their parents' family. Unmarried minors living without their natural/adoptive parents are included in the family of their stepparent, grandparent, or aunt/uncle. Married minor children are placed in a separate family with their spouse and their own children. Children of unmarried minors are placed, along with their minor parent, in the family of their adult grandparents. Foster children and unmarried minors living without any adult family member constitute their own independent families without adults.
About MEPS-HC
MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics.
More information about MEPS is available on the MEPS Web site: http://www.meps.ahrq.gov/.
References
For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize sources on nonsampling error, see the following publications:
Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and Research, 1997.
Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and Research, 1997.
Suggested Citation
Hudson, J. The Uninsured in America, First Half of 2002: Estimates of the Uninsured Living in Working Families for the Civilian Noninstitutionalized Population under Age 65. Statistical Brief #39. May 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://meps.ahrq.gov/mepsweb/data_files/publications/st39/stat39.shtml
Footnote
* Kaiser Family Foundation and Health Research and Educational Trust, Employer Health Benefits: 2002 Annual Survey, September 2002.
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