Figure 1. Employers Provide Health Benefits to More than 160 Million Working Americans and Family Members Source: S. R. Collins, C. White, and J. L. Kriss,

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Presentation transcript:

Figure 1. Employers Provide Health Benefits to More than 160 Million Working Americans and Family Members Source: S. R. Collins, C. White, and J. L. Kriss, Whither Employer-Based Health Insurance? The Current and Future Role of U.S. Companies in the Provision and Financing of Health Insurance (New York: The Commonwealth Fund, Sept. 2007). Data: Current Population Survey, Mar Uninsured 47.0 (16%) Employer (55%) Numbers in millions, 2006 Medicaid 27.9 (9%) Medicare 39.1 (13%) Total population = 296.7Under-65 population = Employer (62%) Uninsured 46.4 (18%) Medicaid 27.9 (11%) Medicare 6.4 (2%) Military 3.4 (1%) Military 3.4 (1%) Individual 16.0 (5%) Individual 15.8 (6%)

Adults ages 19–64 with individual coverage or who thought about or tried to buy it in past three years who: Total Health problem No health problem <200% poverty 200%+ poverty Found it very difficult or impossible to find coverage they needed 34%48%24%43%29% Found it very difficult or impossible to find affordable coverage Were turned down or charged a higher price because of a pre-existing condition Never bought a plan Figure 2. Individual Market Insurance Is Not an Affordable Option for Many People Source: S. R. Collins, J. L. Kriss, K. Davis, M. M. Doty, and A. L. Holmgren, Squeezed: Why Rising Exposure to Health Care Costs Threatens the Health and Financial Well-Being of American Families (New York: The Commonwealth Fund, Sept. 2006).

Figure 3. People with Employer Insurance Have More Stable Coverage than Those with Individual Market Insurance Source: K. Klein, S. A. Glied, and D. Ferry, Entrances and Exits: Health Insurance Churning, 1998–2000 (New York: The Commonwealth Fund, Sept. 2005). Data: Authors’ analysis of the 1998–2000 Medical Expenditure Panel Survey. Employer insurance Individual insurance Retained initial insurance status One or more spells uninsured Other transition 86% 12% 2% 53% 21% 26% Retention of initial insurance over a two-year period, 1998–2000

Source: J. C. Cantor, C. Schoen, D. Belloff, S. K. H. How, and D. McCarthy, Aiming Higher: Results from a State Scorecard on Health System Performance (New York: The Commonwealth Fund, June 2007). Updated data: Two-year averages 1999–2000, updated with 2007 CPS correction, and 2005–2006 from the Census Bureau’s March 2000, 2001 and 2006, 2007 Current Population Surveys. Figure 4. Percent of Uninsured Children Declined Since Implementation of SCHIP, But Gaps Remain U.S. Average: 11.3%U.S. Average: 12.0%

Figure 5. Number of States with 23 Percent or More Uninsured Nonelderly Adults Rose from 2 to 9 in Last Six Years U.S. Average: 20.1%U.S. Average: 17.3% Source: J. C. Cantor, C. Schoen, D. Belloff, S. K. H. How, and D. McCarthy, Aiming Higher: Results from a State Scorecard on Health System Performance (New York: The Commonwealth Fund, June 2007). Updated data: Two-year averages 1999–2000, updated with 2007 CPS correction, and 2005–2006 from the Census Bureau’s March 2000, 2001 and 2006, 2007 Current Population Surveys.

Figure 6. The Majority of Uninsured Adults Are in Working Families Family work statusAdult work status At least one full-time worker 67% Only part-time worker(s) 11% Full-time 49% Part-time 15% No worker in family 21% Not currently employed 36% Note: Percentages may not sum to 100% because of rounding. Source: S. R. Collins, K. Davis, M. M. Doty, J. L. Kriss, and A. L. Holmgren, Gaps in Health Insurance: An All-American Problem (New York: The Commonwealth Fund, Apr. 2006). Adults ages 19–64 with any time uninsured

Figure 7. Employer-Provided Health Insurance, by Income Quintile, 2000–2006 Source: E. Gould, The Erosion of Employment-Based Insurance: More Working Families Left Uninsured, EPI Briefing Paper No. 203 (Washington, D.C.: Economic Policy Institute, Nov. 2007). Percent of population under age 65 with health benefits from employer

Figure 8. Uninsured Rates High Among Adults with Low and Moderate Incomes, 2001–2005 Percent of adults ages 19–64 Note: Income refers to annual income. In 2001 and 2003, low income is <$20,000, moderate income is $20,000–$34,999, middle income is $35,000–$59,999, and high income is $60,000 or more. In 2005, low income is <$20,000, moderate income is $20,000–$39,999, middle income is $40,000–$59,999, and high income is $60,000 or more. Source: The Commonwealth Fund Health Insurance Surveys (2001, 2003, and 2005) TotalLow income Moderate income Middle income High income

Figure 9. Workers Who Are Offered, Eligible for, and Participate in Their Employer’s Health Plan, by Firm Size and Hourly Wage ^ Includes both part-time and full-time workers. Source: S. R. Collins, C. Schoen, D. Colasanto, and D. A. Downey, On the Edge: Low-Wage Workers and Their Health Insurance Coverage (New York: The Commonwealth Fund, Apr. 2003). Updated data from The Commonwealth Fund Biennial Health Insurance Survey (2005). Small employer (fewer than 50 employees) Percent of working adults^ ages 19–64 Medium to large employer (50 or more employees)

Figure 10. Percent Uninsured Workers by Firm Size and Hourly Wage Small employer (fewer than 50 employees) Percent of working adults^ ages 19–64 who are uninsured Medium to large employer (50 or more employees) ^ Includes both part-time and full-time workers. Source: S. R. Collins, C. Schoen, D. Colasanto, and D. A. Downey, On the Edge: Low-Wage Workers and Their Health Insurance Coverage (New York: The Commonwealth Fund, Apr. 2003). Updated data from The Commonwealth Fund Biennial Health Insurance Survey (2005).

Figure 11. Nonstandard Workers Are Less Likely to Have Health Insurance Coverage Through Their Own Job, 2001 Notes: Self-employed independent contractors are excluded from analysis. “Other source of health insurance” includes insurance from the individual market, from another job, from a previous job, or from an association, school, or other unidentified source. Source: E. Ditsler, P. Fisher, and C. Gordon, On the Fringe: The Substandard Benefits of Workers in Part-Time, Temporary, and Contract Jobs (New York: The Commonwealth Fund, Dec. 2005). Data: Authors’ analysis of the 2001 Contingent Work Supplement to the Current Population Survey.

Figure 12. Distribution of Uninsured Young Adults Ages 19–29, by Poverty Status and Race/Ethnicity, 2005 Source: S. R. Collins, C. Schoen, J. L. Kriss, M. M. Doty, and B. Mahato, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help (New York: The Commonwealth Fund, updated Aug. 8, 2007). Data: Analysis of the March 2006 Current Population Survey by S. Glied and B. Mahato for The Commonwealth Fund. Other 7% Hispanic 32% African American 15% White 46% Uninsured young adults = 13.3 million 100%– 199% FPL 31% Less than 100% FPL 41% 200% FPL or more 28%

Figure 13. Percent Uninsured, Children and Young Adults, by Poverty Level, 2005 Percent Uninsured Children Age 18 and Under Young Adults Ages 19–29 Total 11% 30% <100% FPL %–199% FPL1642 >200% FPL716 Source: S. R. Collins, C. Schoen, J. L. Kriss, M. M. Doty, and B. Mahato, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help (New York: The Commonwealth Fund, updated Aug. 8, 2007). Data: Analysis of the March 2006 Current Population Survey by S. Glied and B. Mahato for The Commonwealth Fund.

Figure 14. Uninsured Rates Are High Among Hispanics and African Americans, 2005 Percent of adults ages 19–64 Note: Because of rounding, totals above stacked bars may not reflect the sum of each insurance category. Source: M. M. Doty and A. L. Holmgren, Health Care Disconnect: Gaps in Coverage and Care for Minority Adults (New York: The Commonwealth Fund, Aug. 2006)

Source: J.L. Lambrew, How the Slowing U.S. Economy Threatens Employer-Based Health Insurance (New York: The Commonwealth Fund, Nov. 2001). Updated with data from the Commonwealth Fund Biennial Health Insurance Survey (2005). Figure 15. More Than Half of Unemployed Adults Are Uninsured Percent uninsured, 2005

Below 200% poverty200% poverty or more Other insurance 8% Uninsured 32% COBRA-eligible 75% ESI** small firm 11% ESI** small firm 8% Other insurance 20% COBRA- eligible 40% Uninsured 6% Figure 16. Lower Income Workers Are Least Likely to Be Eligible for COBRA* * The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers with 20 or more employees to offer continuation of health insurance coverage to former employees. ** Employer-sponsored insurance coverage. Source: L. Duchon, C. Schoen, M. M. Doty, K. Davis, E. Strumpf, and S. Bruegman, Security Matters: How Instability in Health Insurance Puts U.S. Workers at Risk (New York: The Commonwealth Fund, Dec. 2001).

Figure 17. People with Disabilities in the Waiting Period for Medicare in 2007, by Source of Coverage Note: Number of people in the waiting period was estimated using the number of SSDI awards to disabled workers, widowers, and adult children in 2004 and 2005 from the Social Security Administration Annual Statistical Supplement (2005 and 2006). Source: S. R. Collins, K. Davis, and J. L. Kriss, An Analysis of Leading Congressional Health Care Bills, : Part I, Insurance Coverage (New York: The Commonwealth Fund, Mar. 2007). Uninsured 264,504 (15%) CHAMPUS 106,697 (6%) Medicaid 644,520 (37%) Employer 567,501 (33%) Non-Group 150,121 (9%) Total people currently in waiting period = 1,733,343

Figure 18. Nearly One-Quarter of Medicare Beneficiaries Were Uninsured Just Before Enrolling Percent of Medicare beneficiaries ages 50–70 Source: S. R. Collins, K. Davis, C. Schoen, M. M. Doty, S. K. H. How, and A. L. Holmgren, Will You Still Need Me? The Health and Financial Security of Older Americans (New York: The Commonwealth Fund, June 2005). Data from the Commonwealth Fund Survey of Older Adults, 2004.

Figure 19. Lacking Health Insurance for Any Period Threatens Access to Care Source: S. R. Collins, K. Davis, M. M. Doty, J. L. Kriss, and A. L. Holmgren, Gaps in Health Insurance: An All-American Problem (New York: The Commonwealth Fund, Apr. 2006). Percent of adults ages 19–64 reporting the following problems in past year because of cost:

Figure 20. Adults Without Insurance Are Less Likely to Be Able to Manage Chronic Conditions Percent of adults ages 19–64 with at least one chronic condition* * Hypertension, high blood pressure, or stroke; heart attack or heart disease; diabetes; asthma, emphysema, or lung disease. Source: S. R. Collins, K. Davis, M. M. Doty, J. L. Kriss, and A. L. Holmgren, Gaps in Health Insurance: An All-American Problem (New York: The Commonwealth Fund, Apr. 2006).

Figure 21. Many Americans Have Problems Paying Medical Bills or Are Paying Off Medical Debt Percent of adults ages 19–64 who had the following problems in past year: * Includes only those who had a bill sent to a collection agency when they were unable to pay it. Source: S. R. Collins, K. Davis, M. M. Doty, J. L. Kriss, and A. L. Holmgren, Gaps in Health Insurance: An All-American Problem (New York: The Commonwealth Fund, Apr. 2006).

Percent of adults reporting: Total Insured all year Insured now, time uninsured during year Uninsured now Unable to pay for basic necessities (food, heat or rent) because of medical bills 26%19%28%40% Used up all of savings Took out a mortgage against your home or took out a loan Took on credit card debt Figure 22. One-Quarter of Adults with Medical Bill Burdens and Debt Were Unable to Pay for Basic Necessities Source: S. R. Collins, K. Davis, M. M. Doty, J. L. Kriss, and A. L. Holmgren, Gaps in Health Insurance: An All-American Problem (New York: The Commonwealth Fund, Apr. 2006). Percent of adults ages 19–64 with medical bill problems or accrued medical debt: