Health Insurance Coverage: Characteristics of the Insured and Uninsured Populations in 2007

Health Insurance Coverage: Characteristics of the Insured and Uninsured Populations in 2007

Order Code 96-891
Updated September 3, 2008
Health Insurance Coverage:
Characteristics of the Insured and
Uninsured Populations in 2007
Chris L. Peterson and April Grady
Domestic Social Policy Division
Summary
Based on data from the Census Bureau’s Current Population Survey (CPS), 45.7
million people in the United States had no health insurance in 2007 — a decrease of
approximately 1.3 million people when compared with 2006. Although it was
statistically unchanged in 2007, the percentage of people covered by employment-based
coverage has dropped in every other year since 2000. Whether the uninsured rate rose
in response depended on how much of the employment-based decrease was offset by
increases in public coverage. In 2007, Medicare and Medicaid coverage rates increased,
and the uninsured rate declined from 15.8% in 2006 to 15.3% in 2007. Mostly because
of Medicare, only 1.9% of those age 65 and older were uninsured in 2007. In contrast,
17.1% of those under age 65 were uninsured. Among the nonelderly uninsured, more
than half were in families with a full-time, full-year worker. Young adults were more
likely to be uninsured than any other age group, and Hispanic individuals had the highest
uninsured rate among race/ethnicity groups.
Health Insurance Coverage, by Population Characteristics
Age. Table 1 provides a breakdown of health insurance coverage by type of
insurance and age in 2007. Compared with other age groups, those under age five had the
highest rates of coverage in Medicaid, the State Children’s Health Insurance Program
(SCHIP), or some other program for low-income individuals (34.0%). Young adults aged
19 to 24 were the most likely to have gone without coverage. While most in this age
group (54.8%) were covered under an employment-based plan, 30.1% had no health
insurance. Some of these young adults lack access to coverage (e.g., because they no
longer qualify as dependents on their parents’ policies and do not have their own
employer offer), and others choose to remain uninsured because they feel that they are in
good health and prefer to spend their income on other priorities. Many age groups
experienced statistically significant decreases in uninsurance in 2007, and Medicaid and
SCHIP coverage rates increased significantly for children and young adults.
Among people age 65 and older, 93.2% were covered by Medicare and less than 2%
were uninsured. The remainder of this report focuses on the nonelderly population.

CRS-2
Table 1. Health Insurance Coverage, by
Type of Insurance and Age, 2007
Type of Insurancea
Medicaid Military or
Uninsured
Population Employment-
Private
or Other
Veterans’
Age
(millions)
basedb
Nongroup Medicare
Publicc
Coverage
(percent) (millions)
Under 19
78.7
60.7%
5.3%
0.7% +
27.6% + 2.8%
11.3%
-
8.9
-
Under 65
262.3
64.4%
6.5%
2.7% +
13.8% + 3.2%
+
17.1%
-
45.0
-
Under 5
20.9
55.6%
4.6%
1.0% +
34.0% + 2.9%
10.5%
-
2.2
5-18
57.7
62.5%
5.5%
0.6%
25.3% + 2.8%
11.6%
-
6.7
-
19-24
24.1
54.8%
5.8%
0.7%
11.4% + 2.9%
30.1%
7.3
25-34
40.1
61.8%
5.8%
1.2%
8.1%
2.6%
+
25.7%
-
10.3
-
35-54
86.1
70.2%
6.9%
3.2%
7.1%
2.7%
16.8%
14.5
55-61
25.3
70.1%
9.3%
7.9%
6.9%
6.0%
12.0%
-
3.0
62-64
8.0
63.1%
11.1%
- 14.8%
8.8%
7.1%
12.3%
1.0
65+
36.8
35.0% -
25.9%
- 93.2% -
8.9%
7.1%
1.9% +
0.7
+
All ages
299.1
60.8%
8.9%
- 13.8% +
13.2% + 3.7%
15.3%
-
45.7
-
Source: CRS analysis of data from the March 2008 Current Population Survey (CPS).
Note: The symbol “+” denotes a statistically significant increase over last year, with “-” denoting a
statistically significant decrease. Statistical significance was tested at the 95% confidence level.
a. People may have more than one source of coverage; percentages may total to more than 100.
b. Includes group health insurance through current or former employer or union and all coverage from
outside the home (published Census Bureau figures are slightly lower due to the exclusion of certain
people with outside coverage). Excludes military and veterans’ coverage.
c. Includes State Children’s Health Insurance Program (SCHIP) and other state programs for low-income
individuals. Excludes military and veterans’ coverage.
Other Demographic Characteristics. Table 2 shows the rate of health
insurance coverage by type of insurance and selected demographic characteristics —
race/ethnicity, family type, region, poverty status, and citizenship — for people under age
65. In 2007, whites were least likely to be uninsured (12.1%), while Hispanics were most
likely (33.5%). The rate of employment-based health coverage was highest among whites
(72.6%), and the rate of public coverage was highest among blacks (26.3%).1 Most of the
race/ethnicity groups shown experienced statistically significant declines in uninsurance
in 2007, and public coverage rates increased significantly for blacks and Hispanics.
People residing in two-parent families were most likely to have employment-based
health insurance (71.8%) and least likely to be uninsured (12.8%). People in a family
headed by a single mother were most likely to have public coverage (40.6%) compared
with other family types, and those in a family headed by a single father were most likely
to be uninsured (24.4%). Public coverage rates increased significantly for both single-
parent and childless families, but findings of significant decreases in uninsurance were
mixed.
1 “Public coverage” includes Medicare, Medicaid, the State Children’s Health Insurance Program
(SCHIP), and any other health insurance program for low-income individuals, but excludes
military and veterans’ coverage. Hispanics may be of any race. In this report, whites, blacks, and
Asians are those who are non-Hispanic and report only one race. Among non-Hispanics,
individuals who report any other single race (e.g., American Indian) or multiple races are
categorized as “other.”

CRS-3
People were less likely to be uninsured if they lived in the Midwest or Northeast
(12.9%) than if they lived in the South (20.7%) or West (18.7%). Employment-based
health insurance covered 70.4% of people in the Midwest and 68.8% in the Northeast,
compared with 60.5% in the South and 61.5% in the West.
Among individuals with family incomes at least two times the poverty threshold,
11.1% went without health insurance compared with 33.6% of the poor (i.e., those with
family incomes below the poverty threshold). Only 16.9% of the poor received health
coverage through employment, and 48.4% had public coverage. Of people with family
incomes at least two times the poverty threshold, 78.9% were covered through an
employer, and only 6.4% had public coverage.
Noncitizens had higher uninsured and lower employment-based coverage rates
(45.3% and 39.7%) than “native” U.S. citizens (14.4% and 66.7%).
Table 2. Health Insurance Coverage, by Type of Insurance and
Demographic Characteristics for People Under Age 65, 2007
Type of Insurancea
Population Employment-
Uninsured
(millions)
Basedb
Publicc
Otherd
(percent) (millions)
Race/ethnicity
White
167.3
72.6%
11.5%
11.1%
12.1%
-
20.3
-
Black
33.3
53.0%
26.3% +
7.3%
20.8%
-
6.9
Hispanic
43.5
42.2%
23.5% +
5.2%
33.5%
-
14.6
-
Asian
11.8
65.8%
11.3%
10.3%
-
17.6%
2.1
Other
6.4
58.0%
23.5%
9.9%
17.6%
-
1.1
-
Family type
Two parents
112.2
71.8%
12.6%
9.6%
12.8%
14.3
-
Single dad with children
8.6
51.1%
23.6% +
7.0%
24.4%
-
2.1
Single mom with children
32.9
40.4%
40.6% +
5.1%
20.6%
6.8
No children
108.7
65.0%
10.6% + 11.1%
20.1%
-
21.8
Region
Northeast
46.7
68.8%
17.3% +
6.8%
12.9%
-
6.0
-
Midwest
57.5
70.4%
14.8%
8.7%
12.9%
7.4
South
96.0
60.5%
15.6% + 10.4%
20.7%
-
19.9
West
62.2
61.5% +
15.3%
11.0%
18.7%
-
11.6
-
Family income-to-poverty ratioe
Less than 100%
33.7
16.9%
-
48.4% +
5.7%
-
33.6%
11.3
100%-149%
22.8
32.3%
34.8%
7.5% 0
32.4%
7.4
150%-199%
21.3
49.0% +
22.2%
9.0%
27.1%
-
5.8
-
200%+
184.1
78.9%
6.4% + 10.6%
11.1%
-
20.4
-
Citizenship
Native
229.4
66.7%
16.2% +
9.9%
14.4%
-
32.9
-
Naturalized
11.9
63.5%
10.6%
10.0%
21.5% +
2.6
+
Noncitizen
20.9
39.7%
12.4% +
5.9%
45.3%
9.5
-
Total
262.3
64.4%
15.6% +
9.5%
17.1%
-
45.0
-
Source: CRS analysis of data from the March 2008 CPS.
Note: The symbol “+” denotes a statistically significant increase over last year, with “-” denoting a
statistically significant decrease. Statistical significance was tested at the 95% confidence level.
a. People may have more than one source of coverage; percentages may total to more than 100.
b. Includes group health insurance through current or former employer or union and all coverage from
outside the home (published Census Bureau figures are slightly lower due to the exclusion of certain
people with outside coverage). Excludes military and veterans’ coverage.

CRS-4
c. Includes Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), and other state
programs for low-income individuals. Excludes military and veterans’ coverage.
d. Includes private nongroup health insurance and military or veterans’ coverage.
e. In 2007, the poverty threshold (which is used mainly for statistical purposes and differs slightly from the
poverty guideline used for program eligibility and other administrative purposes) for a family with
two adults and two children was $21,027. Children are excluded from CPS-based poverty analyses
if they are living with a family to which they are unrelated.
Employment Characteristics. The percentage of people covered by
employment-based coverage was statistically unchanged in 2007. Table 3 shows the rate
of health insurance coverage for people under age 65 by employment characteristics of
the primary worker in the family. In 2007, only 8.5% of workers in large firms (1,000 or
more employees) and their dependents were uninsured, compared with 33.7% in small
firms (less than 10 employees). The category of agriculture, forestry, fishing, and hunting
had the highest proportion of uninsured workers and dependents (35.8%). People
associated with employment in public administration and the armed forces had the lowest
uninsured rates (3.8% and 0.3%). Overall, people in families with a worker experienced
statistically significant declines in uninsurance.
Table 3. Health Insurance Coverage, by Employment
Characteristicsa for People Under Age 65, 2007
Type of Insuranceb
Employment-Basedc
Uninsured
Population
From
From
Public or
(millions)
Own Job Other’s Job
Otherd
(percent) (millions)
People in families with a workere
224.9 35.5%
36.9%
20.2% + 16.3%
-
36.6
-
Firm sizea,e
Under 10
38.2 18.4%
19.2%
35.3% + 33.7%
-
12.9
10-24
19.1 28.5%
26.7%
23.4%
27.8%
5.3
-
25-99
28.2 35.6%
34.8%
19.5%
18.5%
5.2
100-499
31.5 39.6%
40.9%
16.2% + 12.4%
-
3.9
-
500-999
13.4 41.6%
43.2%
- 15.0% +
9.9%
1.3
1,000 +
94.5 41.7% +
44.6%
- 15.8%
8.5%
8.0
Industrya,e
Agriculture, forestry, fishing, and
3.0 16.4%
18.9%
33.4%
- 35.8%
1.1
hunting
Leisure and hospitality
15.0 25.8% +
19.5%
28.9%
32.5%
4.9
Construction
19.8 24.2%
27.9%
23.0% + 31.3%
-
6.2
-
Other services
8.7 25.4%
23.1%
29.8% + 28.9%
2.5
Professional and business
22.9 33.9%
33.8%
- 21.5%
18.8%
4.3
services
Wholesale and retail trade
29.1 34.7%
33.4%
21.7%
18.8%
5.5
Transportation, utilities
14.2 36.1%
41.6%
16.6%
14.8%
2.1
Mining
1.6 34.1%
50.3%
11.0%
12.4%
0.2
Manufacturing
29.9 38.0%
45.3%
13.6%
11.0%
3.3
Education and health services
44.8 42.3%
40.6%
18.6% +
9.3%
-
4.2
-
Information
5.7 43.5% +
44.4%
12.4%
9.2%
0.5
Financial activities
16.0 39.6%
42.8%
17.0%
8.8%
-
1.4
-
Public administration
12.4 44.9%
50.4%
12.6%
3.8%
0.5
Armed forces
1.8 17.7%
29.4%
99.7%
0.3%
0.0
Labor force attachmenta,e
Full time, full year
181.4 37.7% +
40.5%
17.0% + 13.7%
-
24.9
-
Full time, part year
23.3 30.1%
24.3%
- 29.9% + 25.8%
6.0
Part time, full year
12.0 25.3%
23.8%
33.6%
26.6%
3.2 +
Part time, part year
8.2 18.5%
14.2%
44.7%
30.3%
2.5

CRS-5
Type of Insuranceb
Employment-Basedc
Uninsured
Population
From
From
Public or
(millions)
Own Job Other’s Job
Otherd
(percent) (millions)
People in families with no worker or
30.3 12.6%f
9.1%
57.4%
27.7%
8.4
policyholder does not worke
People with coverage outside the
7.1
8.5%
100.0%
18.6%
0.0%
0.0
home
Total
262.3 32.1%
35.4%
24.5% + 17.1%
-
45.0
-
Source: CRS analysis of data from the March 2008 CPS.
Note: The symbol “+” denotes a statistically significant increase over last year, with “-” denoting a
statistically significant decrease. Statistical significance was tested at the 95% confidence level.
a. Firm size, industry and labor force attachment reflect the employment characteristics of the primary
worker in families where someone is working. Those characteristics were applied to those
individuals’ “dependents” — their spouse and children.
b. People may have more than one source of coverage; percentages may total to more than 100.
c. Includes group health insurance through current or former employer or union and all coverage from
outside the home (published Census Bureau figures are slightly lower due to the exclusion of certain
people with outside coverage). Excludes military and veterans’ coverage.
d. Includes Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), other state
programs for low-income individuals, nongroup health insurance, and military or veterans’ coverage.
e. Excluding those persons with health insurance coverage from outside the home.
f. The vast majority of these policyholders (i.e., those who did not work during the year but had
employment-based coverage in their name) were retirees, were ill or disabled, or were at home with
the family and probably received coverage through their former employer.
Characteristics of the Uninsured Population Under Age 65
People who lack health insurance differ from the population as a whole: they are
more likely to be young adults, poor, Hispanic, or employees in small firms. Figure 1
illustrates selected characteristics of those under age 65 who were uninsured in 2007.
Although young adults aged 19 to 24 represented 9.2% of the under-65 population, they
made up 16.2% of the under-65 uninsured. Similarly, Hispanics represented 16.6% of the
population but 32.4% of the uninsured. Whites (non-Hispanics who report being only
white) were the most numerous race/ethnicity group among the under-65 uninsured
(45.1%). More than a quarter of the under-65 uninsured were not native U.S. citizens.
More than half (55.4%) of the under-65 uninsured were full-time, full-year workers or
their spouses and children. About a quarter (26.0%) worked part time or part of the year,
and 18.6% had no attachment to the labor force.
Three-quarters of the under-65 uninsured had family incomes above the poverty
threshold. Even though the poor accounted for only 12.9% of the under-65 population,
they represented 25.2% of the under-65 uninsured. To show money income among the
uninsured, the Census Bureau provides estimates of household income (everyone in the
household) and family income (all related people in the household). Many health policy
analysts also create “health insurance unit” (HIU) income, which is lower than household
or family income, based on people who could be covered under one health insurance
policy (an adult plus spouse and dependents in the household). By this measure of HIU
income, 57% of the under-65 uninsured had income below $25,000 in 2007; 27% had
income between $25,000 and $49,999; 9% had income between $50,000 and $74,999; 3%
had income between $75,000 and $99,999; and 4% had income of $100,000 or more.

CRS-6
Figure 1. Characteristics of the Uninsured U.S. Population Under Age 65, 2007 (45.0 Million)
Age
Race/Ethnicity
Income-to-Poverty Ratio
55 to 64
Under 5
Asian
Less
Other
8.9%
4.9%
4.6%
than
5 to 18
2.5%
Black
100%
14.9%
15.4%
25.2%
200% or
more
35 to 54
White
45.5%
100% to
32.2%
19 to 24
45.1%
149%
16.2%
16.4%
Hispanic
150% to
25 to 34
32.4%
199%
23.0%
12.9%
Citizenship
Firm Size
Ties to Work Force
No
No
Non-
worker
Less
worker
Part
Citizen
in family
than 10
in family
time or
21.1%
18.6%
28.6%
18.6%
part year
26.0%
1,000 or
Naturaliz
more
ed
17.8%
5.7%
10 to 24
500 to
11.8%
Full
Native
100 to
999
25 to 99
time, full
73.2%
499
3.0%
11.6%
year
8.7%
55.4%
Source: Congressional Research Service analysis of data from the March 2008 Current Population Survey.
Note: Totals may not sum to 100% due to rounding. Hispanics may be of any race. In this chart, whites, blacks and Asians are those who are non-Hispanic and report only one race.
Among non-Hispanics, individuals who report any other single race (e.g., American Indian) or multiple races are categorized as “other.” “Firm size” and “ties to work force” reflect
the employment characteristics of the primary worker in families where someone is working. Those characteristics were applied to those individuals’ “dependents” — their spouses
and children. Employed policyholders of private coverage are first to be assigned as primary workers. For those in families without private coverage, persons’ employment
characteristics are those of the family head or, if the head is not employed and the spouse is, the spouse.