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STATISTICAL BRIEF #71:
The Health Insurance Status of U.S. Workers, 2003: Estimates for Civilian Noninstitutionalized Workers Ages 16-64

March 2005

William Carroll, BS

Highlights

Workers with the following job characteristics were most likely to be uninsured: the self-employed, those working in small businesses, those earning low wages, and part-time workers.
Workers who were self-employed were almost twice as likely as wage earners to be uninsured.
The risk of being uninsured was related to size of business. Wage earners were more likely to be uninsured if they worked for establishments with fewer than 10 employees.
Workers earning less than $10.00 per hour were at substantially greater risk of lacking health insurance than those earning $10.00 or more per hour.
Over three-fourths of full-time workers had job-related insurance.

Introduction

For most Americans, health insurance obtained through the workplace is the primary source of private coverage, whether as a policyholder or as a dependent on a family member's plan. Data from the Household Component of the 2003 Medical Expenditure Panel Survey (MEPS-HC) indicate that nearly two-thirds (63.4 percent) of Americans under 65 years of age had job-related health insurance during the first half of 2003. However, employment does not necessarily lead to health insurance coverage for many working Americans. Nearly a fifth (18.6 percent) of working Americans ages 16-64 were uninsured during the first half of 2003 (approximately 25 million people). These workers represented 53.7 percent of the total uninsured population. MEPS data also indicate that certain job characteristics, such as self-employment, size of business, hourly wages, and weekly hours of work, are strongly associated with workers' health insurance status.

Findings

Self-employed people were nearly twice as likely as wage earners to be uninsured during the first half of 2003. Roughly 31 percent of self-employed people lacked any type of health insurance, compared to 17 percent of wage earners (figure 1).

MEPS-HC data also indicate that size of business is a factor that distinguishes whether or not a worker has health insurance, regardless of whether the worker is self-employed or a wage earner. The self-employed with small businesses of fewer than 10 workers were 1.69 times as likely to be uninsured as those with businesses of 10 or more workers (27 percent and 16 percent, respectively; data not shown). For wage earners the situation is similar. Thirty percent of wage earners in establishments with fewer than 10 workers were uninsured, but only 6 percent of those in large establishments (more than 500 workers) were uninsured (figure 2). Wage earners in establishments with fewer than 10 employees represented 18 percent of all such workers but accounted for 33 percent of the uninsured wage earners (figure 3).

Wage earners who earned low hourly wages also were at greater risk of being uninsured. Only 53 percent of workers earning less than $10.00 per hour obtained job-related coverage, in contrast to 93 percent of workers earning $15.00 or more per hour (data not shown). About 33 percent of workers earning less than $10.00 per hour and 17 percent of workers earning $10.00-$14.99 per hour were uninsured, compared to only 3 percent of workers earning $20.00 or more per hour (figure 4).

Part-time workers (those working less than 35 hours per week) were more likely than full-time workers to be uninsured (figure 5). Approximately 58 percent of part-time workers had job-related insurance (data not shown), compared to 78 percent of full-time workers.

Data Source

The estimates shown in this Statistical Brief are derived from the MEPS Point-in-Time File HC-064. Nonresponse rates for the items reported in this brief ranged from 0.0 percent to 2.9 percent.

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.

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1406) or visit the MEPS Web site at 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.

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, July 2003: 41(7) Supplement: III-5-III-12.

Suggested Citation

Carroll, W. The Health Insurance Status of U.S. Workers, 2003: Estimates for Civilian Noninstitutionalized Workers Ages 16-64. Statistical Brief #71. March 2005. Agency for Healthcare Research and Quality, Rockville, Md. http://meps.ahrq.gov/mepsweb/data_files/publications/st71/stat71.shtml

Table containing figure values follows image.

	Self-employed	Wage earners
Figure 1. Percentage uninsured for workers ages 16-64, first half of 2003
Percent	31	17
Source: Center for Financing, Access and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, Point-in-Time File HC-064, 2003

	Less than 10 workers	10-24 workers	25-49 workers	50-99 workers	100-499 workers	500 or more workers
Figure 2. Percentage uninsured for wage earners ages 16-64, by size of establishment, first half of 2003
Percent	30	22	18	14	9	6
Source: Center for Financing, Access and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, Point-in-Time File HC-064, 2003

	Less than 10 workers	10-24 workers	25-49 workers	50-99 workers	100-499 workers	500 or more workers
Figure 3. Percentage wage earners ages 16-64, by size of establishment and uninsured status, first half of 2003
All wage earners	18%	17%	13%	13%	22%	17%
Uninsured wage earners	33%	22%	14%	12%	12%	7%
Source: Center for Financing, Access and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, Point-in-Time File HC-064, 2003

	Less than $10.00	$10-$14.99	$15-$19.99	$20.00 or more
Figure 4. Percentage uninsured for wage earners ages 16-64, by hourly wage, first half of 2003
Percent	33	17	7	3
Source: Center for Financing, Access and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, Point-in-Time File HC-064, 2003

	Less than 20 hours	20-34 hours	35 or more hours
Figure 5. Percentage with job-related insurance for workers ages 16-64, by number of hours worked per week, first half of 2003
Percent	61	57	78
Source: Center for Financing, Access and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, Point-in-Time File HC-064, 2003

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STATISTICAL BRIEF #71: The Health Insurance Status of U.S. Workers, 2003: Estimates for Civilian Noninstitutionalized Workers Ages 16-64