American families are struggling to find affordable health coverage. The average premium for family health insurance is almost $10,000, and many employers are dropping
coverage or requiring their employees to contribute more than they can afford to pay.
The result has been a steep increase in the number of Americans without health insurance. Yesterday, the U.S. Census Bureau announced that the number of uninsured
Americans rose to 45.8 million last year, an increase of 6 million people since 2000.
The uninsured, who are overwhelmingly members of working families, have less access
to care, are in poorer health, and are at greater risk of premature death. In addition to
the serious health consequences, lack of insurance also creates financial hardships:
medical bills are a leading contributor to personal bankruptcy.
Almost 46 million Americans are living without health insurance. The number of
uninsured Americans has increased each year during the Bush Administration. After
decreasing at the end of the 1990s, the number of Americans without health insurance
has increased from 39.8 million in 2000 to 45.8 million in 2004. A major cause is a decline in employer-sponsored health coverage: the number of people receiving health
coverage through an employer decreased from 63.6 percent in 2000 to 59.8 percent in
2004. The uninsured problem would have grown even worse if government health insurance programs were not available: the number of people who reported being covered by Medicaid increased by almost 2 million between 2003 and 2004. (U.S. Census
Bureau, August 30, 2005)
Not having health insurance has serious health consequences. The number of
uninsured Americans is more than a statistic; it is a grim reality for many Americans.
Extensive study has refuted the myth that the uninsured receive the health care they
really need. The Institute of Medicine (IOM), an independent panel of experts, found
that the uninsured receive an inferior level of care that contributes to poor health and
premature death. The uninsured are more likely to forgo needed care, receive fewer
preventive services, not receive appropriate care to manage chronic diseases such as
cardiovascular disease and diabetes, and obtain substandard care when admitted to a
hospital. The IOM estimated that about 18,000 unnecessary deaths are attributable to
lack of health insurance each year. (IOM, May 2002)
Millions of additional Americans lack adequate health insurance. In addition to the
45.8 million uninsured Americans, about 16 million people are underinsured, which
means their health coverage does not adequately protect them from catastrophic health
care expenses. Underinsured Americans are almost as likely as the uninsured to not
receive needed medical care and have difficulty paying for medical care. According to a
Commonwealth Fund survey, 54 percent of the underinsured report going without needed care and 46 percent report being contacted by a collection agency for medical bills.
(Schoen et al., Health Affairs, June 14, 2005)
The Bush Administration has failed to respond to concerns about unaffordable
health coverage. Making health care more affordable for working families and expanding coverage to the uninsured has not been a priority for the Bush Administration. The
problem has grown worse, not better. Proposals offered by the President, such as Association Health Plans and tax deductions for high-deductible policies that accompany
Health Savings Accounts, would provide little benefit to the uninsured and would actually make some people worse off by undermining employer-sponsored coverage and reducing the cross-subsidies that keep premiums more affordable for people in less-than-perfect health. Moreover, the Administration has targeted Medicaid, the program
most responsible for preventing the number of uninsured from climbing even higher in
recent years, for substantial cuts. In fact, following the President's lead, Congressional
Republicans are attempting to cut Medicaid spending by $10 billion over the next five
years.
