A Portrait of the Uninsured

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A Portrait of the Uninsured

• The Institute for Urban Family Health
• Susanne Callahan
• Kenya Lucas

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Question 1

• Which of the following statements is true?
• a. The number of Americans without health
  insurance has grown, even when the economy is
  strong.
• b. The uninsured represent about 15 percent of
  the population.
• c. Uninsured Americans come from every race, age,
  and ethnic group.
• d. All of the above.

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Answer 1

• Which of the following statements is true?
• a. The number of Americans without health
  insurance has grown, even when the economy is
  strong.
• b. The uninsured represent about 15 percent of
  the population.
• c. Uninsured Americans come from every race,
  age, and ethnic group.
• d. All of the above.

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Explanation

• More than 41 million Americans lack health
  insurance.
• Of these, 8.5 million are children under age 18.
• Over the past quarter century, the number of
  uninsured Americans has increased by about 1
  million a year -- faster than the rate of the
  overall population growth.

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Percentage Uninsured Among Adults Ages 18-64, by
Age, 2001
Source Employee Benefit Research Institute
estimates from the March Current Population
Survey, 2002 Supplement.
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What does this mean for NYC?
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Question 2

• Who is most likely to be uninsured? People who
• a. Earn low incomes.
• b. Have less education.
• c. Are Hispanic.
• d. Are 18 to 24 years old.
• e. All of the above.

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Answer 2

• Who is most likely to be uninsured? People who
• a. Earn low incomes.
• b. Have less education.
• c. Are Hispanic.
• d. Are 18 to 24 years old.
• e. All of the above.

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Explanation

• Being poor doesnt necessarily mean a person will
  be covered by Medicaid.
• Most low-income workers work in businesses that
  dont provide health coverage.
• Having a college degree leads to higher paying
  jobs which often include health benefits.
• Hispanics and blacks are more likely to lack
  health coverage than non-Hispanic whites.

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Explanation

• My patients are hard-working people who often
  hold not one but as many as three jobs to pay
  their bills, clothe their children, and put food
  on the table. Most of them earn just enough to
  be ineligible for MedicaidThey are forced to
  decide between paying rent and getting the health
  care they need.
• Margaret Pereyda, physician

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Question 3

• Which of the following statements are true?
• a. African Americans are twice as likely as
  non-Hispanic whites to be without health
  insurance.
• b. Hispanics are three times as likely as whites
  to be without health insurance.
• c. All of the above.
• d. None of the above.

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Answer 3

• Which of the following statements are true?
• a. African Americans are twice as likely as
  non-Hispanic whites to be without health
  insurance.
• b. Hispanics are three times as likely as whites
  to be without health insurance.
• c. All of the above.
• d. None of the above.

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Explanation

• Lower rates of health coverage from jobs
• Lower family incomes
• No national health care coverage

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What does this mean for NYC?
Publicly Insured by Race
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What does this mean for NYC?
Uninsured by Race
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Question 4

• What proportion of adults and children without
  health insurance live in families in which
  someone works?
• a. 7 percent
• b. 20 percent
• c. 40 percent
• d. 80 percent

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Answer 4

• What proportion of adults and children without
  health insurance live in families in which
  someone works?
• a. 7 percent
• b. 20 percent
• c. 40 percent
• d. 80 percent

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Explanation

• More than 80 percent of uninsured children and
  adults under age 65 live in working families.
• Even members of families with two full-time wage
  earners have a good chance of being uninsured.

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Distribution of Uninsured Workers, Ages 18-64, by
Work Status, 2001
Source Employee Benefit Research Institute
estimates from the March Current Population
Survey, 2002 Supplement.
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Explanation

• Its gotten to the point where some people are
  working just to get health insurance. I know
  someone who makes 9 an hour, and pays 8 an hour
  for childcare. They take home nothing, but the
  job comes with health coverage, so they keep it.
• Joe Babbitt, physician

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Question 5

• What proportion of people without health
  insurance are members of lower income families?
• a. one-fourth
• b. one-half
• c. two-thirds
• d. three-fourths

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Answer 5

• What proportion of people without health
  insurance are members of lower income families?
• a. one-fourth
• b. one-half
• c. two-thirds
• d. three-fourths

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Explanation

• Two-thirds of all uninsured people are members of
  families earning less than 200 percent of the
  federal poverty level.
• For a family of four, that means they earned less
  than 34,000 in 1999.
• Many low-income families are ineligible for
  public health insurance such as Medicaid.

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Percentage Uninsured Among the Nonelderly
Population, by Family Poverty Status, 2001
Source Employee Benefit Research Institute
estimates from the March Current Population
Survey, 2002 Supplement
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Question 6

• Immigrants account for which proportion of people
  without health insurance?
• a. 1 in 2
• b. 1 in 3
• c. 1 in 4
• d. Fewer than 1 in 5

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Answer 6

• Immigrants account for which proportion of people
  without health insurance?
• a. 1 in 2
• b. 1 in 3
• c. 1 in 4
• d. Fewer than 1 in 5

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Explanation

• Recently arrived immigrants -- those who have
  been in the country four years or less -- have a
  higher than average uninsured rate, but they
  comprise a relatively small proportion of the
  total population.

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Question 7

• What could cause you to lose your health
  insurance?
• a. You could lose your job and the
  employment-based insurance that came with it.
• b. You could get divorced and no longer be
  considered a dependent on your ex-spouse's
  coverage.
• c. Your insurance payment could be increased
  beyond the level you can afford.
• d. All of the above.

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Answer 7

• What could cause you to lose your health
  insurance?
• a. You could lose your job and the
  employment-based insurance that came with it.
• b. You could get divorced and no longer be
  considered a dependent on your ex-spouse's
  coverage.
• c. Your insurance payment could be increased
  beyond the level you can afford.
• d. All of the above.

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Explanation

• Many common life events can trigger a loss or
  gain of health insurance coverage.
• The average time without coverage is 5 -6 months,
  but people with low income and less education are
  likely to be without coverage for even longer.
• Changes in Medicaid or other public insurance
  programs can cause gaps in coverage

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Question 8

• How likely are people without health insurance to
• gain access to the health services they need?
• a. Very likely -- they have access to emergency
  medical care, public clinics, and other services.
• b. Significantly less likely than people with
  insurance-- they receive fewer preventive
  services (like pap smears and check-ups) and less
  care for chronic conditions (like diabetes and
  hypertension).
• c. Having health insurance makes little
  difference in the type of care people receive.
• d. None of the above.

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Answer 8

• How likely are people without health insurance to
• gain access to the health services they need?
• a. Very likely -- they have access to emergency
  medical care, public clinics, and other services.
• b. Significantly less likely than people with
  insurance-- they receive fewer preventive
  services (like pap smears and check-ups) and less
  care for chronic conditions (like diabetes and
  hypertension).
• c. Having health insurance makes little
  difference in the type of care people receive.
• d. None of the above.

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Explanation

• People without insurance are much less likely
  than people with insurance to get the health care
  they need they receive fewer preventive
  services and less care for chronic conditions.

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What does it mean for NYC?
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Explanation

• One woman described trying to get help for
• her child who had become cross-eyed. It
• wasnt until I got a job and I had job
• insurance that she was able to get a
• doctor to pay attention. Just the way I was
• treated with that job coverage, as opposed
• to Medicaid. It felt really good. I felt like I
• had money!
• Patient

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Explanation

• If you aint got money, you just got to have
  patience cause places is overcrowded.Youve got
  to have money. Thats the bottom line. You got
  to brace yourself to that.
• Patient