Health Insurance Coverage in the U.S., 2009 NOTE: Includes those over age 65. Medicaid/Other Public...
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Transcript of Health Insurance Coverage in the U.S., 2009 NOTE: Includes those over age 65. Medicaid/Other Public...
Health Insurance Coverage in the U.S., 2009
NOTE: Includes those over age 65. Medicaid/Other Public includes Medicaid, CHIP, other state programs, military-related coverage, and those enrolled in both Medicare and Medicaid (dual eligibles). SOURCE: Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on the Census Bureau's March 2010 Current Population Survey.
Total = 303.3 million
U.S. unemployment rate
Nonelderly Uninsured by Poverty Levels and Age, 2009
Total = 50.0 million uninsured
Note: Federal Poverty Level (FPL) for a family of four in 2009 is $22,050/year.SOURCE: KCMU/Urban Institute analysis of 2010 ASEC Supplement to the CPS.
<138% FPL
139-399% FPL
400%+ FPL
Children
10%
Adults42%
Children
6%
Adults 33%
Children1%
Adults8%
Employer-sponsored Insurance
57%
Medicaid/ Other Public
19%
Uninsured19%
Health Insurance Coverage ofthe Nonelderly Population, 2009
264.7 Million
SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2010 ASEC Supplement to the CPS.
Private Non-group 5%
Health Insurance Coverage of the Nonelderly by Poverty Level,
2009
30%
54%
38%
21%
36%25%
13%
79%
18%
91%
8%
46%
4%33%
5%
<100% FPL 100-138%FPL
139-250%FPL
251-399%FPL
400% + FPL
Employer/ Other Private Medicaid/ Other Public Uninsured
The federal poverty level (FPL) was $22,050 for a family of four in 2009. Data may not total 100% due to rounding. SOURCE: KCMU/Urban Institute analysis of 2010 ASEC Supplement to the CPS.
Number of Nonelderly Uninsured Americans,2000 – 2009
* The Census Bureau periodically revises its CPS methods, which means data before and after the revision are not comparable. Comparison across years can be made between 2000 through 2004, and 2004 though 2009.SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2001-2010 ASEC Supplements to the CPS.
Number of Nonelderly Uninsured Americans,2004 - 2009
37.0 36.1 37.6
8.4 8.7 9.4 8.9 8.18.3
34.6 35.641.7
2004 2005 2006 2007 2008 2009
ChildrenAdults
Uninsured in Millions
SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of March CPS for each year.
43.0 44.4 46.5 45.0 45.750.0
Characteristics of the Uninsured, 2009
400% FPLand Above
10%251-399% FPL
13%
100-250% FPL38%
<100% FPL40%
Family IncomeFamily Work Status
Total = 50.0 million uninsured
1 or More Full-Time Workers
61%
No Workers
23%
Part-TimeWorkers
16%
Age
55-6410%
35-5433%
19-3440%
0-1817%
The federal poverty level was $22,050 for a family of four in 2009. Data may not total 100% due to rounding. SOURCE: KCMU/Urban Institute analysis of 2009 ASEC Supplement to the CPS.
Nonelderly’s Health Insurance Coverage by Family Poverty Level,
2009
55.6 M
46.9 M
73.5 M
88.7 M
Number
Under 100%
100% - 199%
200% - 399%
400% +
NOTES: Data may not total 100% due to rounding. The Federal Poverty Level for a family of four in 2009 was $22,050 (according to the U.S. Census Bureau’s poverty threshold). Family size and total family income are grouped by insurance eligibility. SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2010 ASEC Supplement to the CPS.
Nonelderly’s Health Insurance Coverage by Family Work Status,
2009
68.2 M
135.4 M
24.1 M
37.1 M
Number
Two full-time workers
One full-timeworker
Only part time
No workers
NOTES: Data may not total 100% due to rounding. SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2010 ASEC Supplement to the CPS.
Uninsured Rates Among Nonelderly by State, 2008-2009
<14% Uninsured (13 states & DC)
14 to 18% Uninsured (20 states)National Average = 18.1%
SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2009 and 2010 ASEC Supplements to the CPS., two-year pooled data.
AZ
WA
WY
ID
UT
OR
NV
CA
MT
HI
AK
AR
MS
LA
MN
ND
CO
IA
WISD
MOKS
TN
NMOK
TX
AL
MI
ILOH
IN
KYNC
PA
VAWV
SC
GA
FL
ME
NY
NH
MA
VT
NJ
DE
MD
RI
DC
CT
>18% Uninsured (17 states)
NE
Children’s Health Insurance Coverage by Family Poverty Level,
2009
21.5 M
15.8 M
21.7 M
20.3 M
Number
Under 100%
100% - 199%
200% - 399%
400% +
NOTES: The Federal Poverty Level for a family of four in 2009 was $22,050 (according to the U.S. Census Bureau’s poverty threshold). Family size and total family income are grouped by insurance eligibility. Children includes all individuals under age 19.SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2010 ASEC Supplement to the CPS.
Access to Employer-Based Coverage by Family Income, 2005
30%
92%
55%
4%
15%
4%
Poor Workers Higher Income Workers
Covered by Ownor Spouse'sEmployer
Declined offerfrom Own orSpouse'sEmployer
Not offeredthrough Own orSpouse'sEmployer
NOTE: The Federal Poverty Level (FPL) was $16,090 for a family of three in 2005.SOURCE: Garrett B. and L. Clemens-Cope. Changes in Employer-Sponsored Health Insurance Coverage: 2001-2005. Kaiser Commission on Medicaid and the Uninsured report #7599, Dec. 2006
(Family Income <100% FPL)
(Family Income 400%+ FPL)
3% 3%1%
4%5%3% 2% 2%
6%
29%
23%
14% 13%
28%
34%
2%
12%15%
No Usual Souceof Care
PostponedSeeking CareDue to Cost*
Went WithoutNeeded CareDue to Cost*
Last MD Contact>2 Years Ago
Unmet DentalNeed Due to
Cost*
Last Dental Visit>2 Years Ago
Employer/ Other Private Medicaid/ Other Public Uninsured
Children’s Access to Care, by Health Insurance Status, 2009
* In the past 12 monthsNOTE: Questions about dental care were analyzed for children age 2-17. MD contact includes other health professionals. Respondents who said usual source of care was the emergency room were included among those not having a usual source of care. SOURCE: Kaiser Commission on Medicaid and the Uninsured analysis of 2009 NHIS data.
Barriers to Health Care Among Nonelderly Adults, by Insurance
Status, 2009
6%
4%
6%
11%
13%
9%
6%
11%
27%
26%
42%
55%
Could Not AffordPrescription
Drug*
Went WithoutNeeded Care Due
to Cost*
No PreventiveCare
No Usual Sourceof Care
Uninsured
Medicaid/ Other Public
Employer/ Other Private
* In past 12 months.Respondents who said usual source of care was the emergency room were included among those not having a usual source of care.SOURCE: KCMU analysis of 2009 NHIS data.
Percent of adults (age 18 – 64) reporting:
Diagnosis of Late-Stage CancerUninsured vs. Privately Insured
2.9
2.32.22.0
0.0
0.5
1.0
1.5
2.0
2.5
3.0
ColorectalCancer
Lung Cancer Melanoma Breast Cancer
NOTE: Odds ratios were adjusted for age, sex, race/ethnicity, facility type, region, and income and education on basis of postal code. They represent the odds of being diagnosed with stage III or state IV cancer vs. stage I cancer.Analysis based on cases occurring between 1998-2004.SOURCE: Kaiser Family Foundation, based on Halpern MT et al, Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: a retrospective analysis." The Lancet Oncology. March 2008.
Equal likelihood between
Uninsured and Insured
Ratio of probability of diagnosis of late vs. early stage cancer, Uninsured/private insurance
*No data are available for 2007 due to MEPS transition from retrospective to current data collection.
Note: Family premium percentages were calculated based on a family of four. In 2009 and 2010, the federal poverty level for a family of four was $22,050.
Source: Premium data from Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, private sector data from Insurance Component, 1996-2009, at http://www.meps.ahrq.gov/mepsweb/. Federal Poverty Level based on HHS Federal Poverty Guidelines (1996 through 2009) at http://aspe.hhs.gov/poverty/figures-fed-reg.shtml; rate of growth based on change for one person (change for a four-person family would be 41.3% rather than 39.9% over the period).
Cumulative Change in Single and Family Health Insurance Premiums and Federal Poverty Level,
1996-2009
*
*
Medicaid Managed Care and Traditional Enrollment, 1999-2009
Note: Numbers may not produce totals because of rounding. Unduplicated count. Includes managed care enrollees receiving comprehensive and limited benefits.
SOURCE: 2009 Medicaid Managed Care Enrollment Report. CMS.
Enrollment (in millions)
31.9 33.736.6
40.142.7 44.4 45.4 45.7 46.0 47.1
Financial Consequences of Medical Bills by Insurance
Status, 2009
9%
5%
10%
22%
14%
20%
Contacted byCollection Agency
about MedicalBills
Unable to Pay forBasic NecessitiesDue to Medical
Bills
Used up All orMost of Savings
Insured
Uninsured
NOTE: All differences between insured and uninsured are statistically significant (p<0.05).SOURCE: Kaiser Family Foundation Health Tracking Poll: August 2009.
Percent of adults (age 18-64) reporting in past 12 months:
January 2007
December 2007
January 2006
Figure 2: Among Adults with Employer-Sponsored Coverage or Nongroup Coverage in January 2006, Percent Uninsured in Each Month, January 2006 to
December 2007
Source: Kaiser Family Foundation analysis using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), 2006 and 2007.
January 2007
December 2007
January 2006
Figure 3: Among Adults with Medicaid in January 2006, Percent Uninsured in Each Month, January
2006 to December 2007
Source: Kaiser Family Foundation analysis using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), 2006 and 2007.
January 2007
December 2007
January 2006
Figure 6: Among Adults Without Health Insurance in January 2006, Percent with Health Insurance in Each
Month, January 2006 to December 2007
Note: Family income is based on income in 2006.
Source: Kaiser Family Foundation analysis using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), 2006 and 2007.
January 2007
December 2007
January 2006
Figure 5c: Among Children Without Health Insurance in January 2006, Percent with Health Insurance in
Each Month, January 2006 to December 2007
Note: Family income is based on income in 2006.
Source: Kaiser Family Foundation analysis using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), 2006 and 2007.
Decrease in Employer
Sponsored Insurance
(million)2.8%
National Unemployme
nt Rate Increase
since 2008(from 7.2% in
Dec-08 to 10.0% in Nov-09)
=
2.8 3.0
Medicaid /CHIP
Enrollment Increase(million)
Uninsured Increase(million)
&
6.9
Note: Totals may not sum due to rounding and other coverage.Source: Based on John Holahan and Bowen Garrett, Rising Unemployment, Medicaid, and the Uninsured, prepared for the Kaiser Commission on Medicaid and the Uninsured, January 2009.
Impact of the Rise in Unemployment on Health Coverage, 2008 to 2009
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
<15K 15K to20K
20K to25K
25K to30K
30K to35K
35K to40K
40K to50K
>=50K
1,000 or More Workers
100-999 Workers
25-99 Workers
10-24 Workers
1-9 Workers
Establishment Offer Rates by Size and Average Worker Earnings, 2000-
2005
Notes: Wages cutoffs are adjusted for inflation to 2005 dollars.
Source: Kaiser Family Foundation calculations based on data from the National Compensation Survey, 2000-2005, conducted by the Bureau of Labor Statistics.
Off
er
Rate
Average Worker Earnings
Among Workers in Firms Offering Health Benefits, Percentage of Workers Eligible, Who Take Up, and Covered by Health Benefits Offered by Their Firm,
by Wage Level, 2008
*Estimates are statistically different from each other within category (p<.05).
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2008.
Take Up*
Coverage*
52%
68%
74%
83%
71%
81%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Eligibility*
Many Workers Are Lower-Wage (35% or More Earn $22,000 a Year or Less)
Few Workers Are Lower-Wage(Less Than 35% Earn $22,000 a Year or Less)
Many Workers Are Lower-Wage (35% or More Earn $22,000 a Year or Less)
Few Workers Are Lower-Wage(Less Than 35% Earn $22,000 a Year or Less)
Many Workers Are Lower-Wage (35% or More Earn $22,000 a Year or Less)
Few Workers Are Lower-Wage(Less Than 35% Earn $22,000 a Year or Less)
Nearly Two-Thirds of States Expanded Access to Medicaid and
SCHIP, July 06 – January 08
SOURCE: Based on a national survey conducted by the Center on Budget and Policy Priorities for the Kaiser Commission on Medicaid and the Uninsured, 2008.
32
26
11
7
Total EligibilityIncreases
EnrollmentProcedure
Simplifications
ReducedChildren'sPremiums
Number of States With…
HMO Enrollment, by Model Type, 1984-2006
Note: HMO enrollment includes enrollees in both traditional HMOs and point-of-service (POS) plans through: group/commercial plans, Medicare, Medicaid, the Federal Employees Health Benefits Program, direct pay plans, and unidentified HMO products. Enrollment by model type may not equal total enrollment because some plans did not report these characteristics. Data are as of June 30 or July 1 of respective year.
Source: Kaiser Family Foundation, Trends and Indicators in the Changing Health Care Marketplace, 2002, May 2002, Exhibit 2.5, p.20, at http://www.kff.org/insurance/3161-index.cfm, based on July 1 data from InterStudy Publications, updated most recently with data from HealthLeaders-InterStudy, The Competitive Edge, Part II: Managed Care Industry Report, March 2007, Table 10, p.25.
6.7
23.132.1 31.8 28.5 29.3 28.9
24.0 24.8
2.913.5
16.2
27.5
33.5 31.929.9 25.4
21.526.6
18.1
5.6
3.9
3.3
7.1 6.98.3
7.88.3 11.3
11.3
6.6
8.0
9.7
8.7
7.0 7.27.4
7.37.2
7.4
8.2
3.5
0.2
0.60.2
0.20.2
0.20.4
0.8
2.4
4.3
2.1
0
10
20
30
40
50
60
70
80
90
1984 1988 1992 1996 2000 2001 2002 2003 2004 2005 2006
Mixed IPA Network Group Staff
15.1
31.4
38.8
63.3
80.1 78.074.2
70.066.1
71.4
Enrollees (in millions)
72.7
Distribution of HMO Enrollment by Ownership Status, 1981-2006
Note: Some plans failed to report profit status and are excluded from the analysis. HMO enrollment includes enrollees in both traditional HMOs and point-of-service (POS) plans through: group/commercial plans, Medicare, Medicaid, the Federal Employee Health Benefits Program, direct pay plans, and unidentified HMO products. Data are as of June 30 or July 1 of respective year.
40.237.940.338.337.337.436.536.036.336.747.8
53.8
74.0
88.0
52.246.2
26.012.0
63.3 63.7 64.0 63.5 62.6 62.7 61.7 59.7 60.6 59.8
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1981 1985 1989 1993 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Percentage For-Profit
Percentage Non-Profit
10.3 18.9 32.5 42.1
72.2 78.8 80.8
79.7
78.0 74.2 70.0 66.1 71.4 72.7
Total Enrollment (in millions):
Source: Kaiser Family Foundation, Trends and Indicators in the Changing Health Care Marketplace, 2002, May 2002, Exhibit 5.10, p. 57, at www.kff.org/insurance/3161-index.cfm, based on July 1 data from InterStudy Publications, updated most recently with data from HealthLeaders-InterStudy, The Competitive Edge, Part II: Managed Care Industry Report, March 2007, Table 10, p.25.
+5.6 million
Growth in Workers in Industries where Employer-Sponsored
Health Coverage is Less Common
Decline in Workers in Industries where Employer-Sponsored
Health Coverage is More Common
-2.0 million
Growth in Workers by Type of Industry, 2000 to 2005
Notes: Excludes those aged 65+. Uninsured rates are 23% in industries where coverage is less common, such as construction and agriculture; 10% where coverage is more common, such as education and manufacturing.Source: Urban Institute analysis of the 2001 and 2006 March CPS for KCMU, 2006.