Health Insurance Coverage: Characteristics of the Insured and Uninsured Populations in 2001

Health Insurance Coverage: Characteristics of the Insured and Uninsured Populations in 2001

Order Code 96-891 EPW
Updated November 7, 2002
CRS Report for Congress
Received through the CRS Web
Health Insurance Coverage:
Characteristics of the Insured and
Uninsured Populations in 2001
Chris L. Peterson
Analyst in Social Legislation
Domestic Social Policy Division
Summary
The number of Americans without health insurance rose in 2001 to 41.2 million
Americans (14.6%) — an increase of 1.4 million people from 2000. This reverses a
two-year trend of falling numbers of uninsured. Approximately 1.3 million fewer
Americans had employment-based health coverage, compared to 2000, according to the
Census Bureau. From 1999 to 2000, this number had risen by 2.9 million. In spite of
the decline, most Americans (64.1%) still receive their health insurance through an
employer. Yet full-time, full-year workers and their family members make up more than
half of the uninsured. The percentage of individuals covered by Medicaid increased
significantly in 2001. Among children in 2001, the percentage of uninsured did not
change significantly. This report examines characteristics of both the insured and the
uninsured populations in the United States. It will be updated annually.
Health Insurance Coverage and Selected
Population Characteristics
Age. Table 1 provides a breakdown of health insurance coverage by type of
insurance and age. In 2001, compared to other age groups, those under age 5 were most
likely (29%) to have coverage through Medicaid, the State Children’s Health Insurance
Program (SCHIP), or some other program for low-income individuals. Young adults ages
19 to 24 were the most likely to have gone without health insurance for the entire year.
While most in this age group (57%) were covered under an employment-based plan, 30%
had no health insurance. Young adults are often too old to be covered as dependents on
their parents’ policies and, as entry-level workers, do not have strong ties to the work
force. In addition, some may choose to remain uninsured and spend their money on other
items. After age 25, the percentage of people without health insurance decreases. Of
those age 65 and over, 96% were covered by Medicare, and less than 1% were uninsured
for the entire year. The remainder of this report focuses on the population under age 65.
Congressional Research Service ˜ The Library of Congress

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Table 1. Health Insurance Coverage by
Type of Insurance and Age, 2001
Type of insurancea
Medicaid Military/
Population
Employment
Private
or other
veterans
Age
(in millions)
basedb
nongroup Medicare
publicc
coverage
Uninsured
Under 5
19.4
60.8%
4.8%
0.7%
28.5%
3.5%
10.6%
5-18
57.1
66.3
5.1
0.6
20.2
3.2
12.6
19-24
23.4
57.3
6.0
0.7
9.6
2.7
29.7
25-34
38.7
66.2
5.3
1.3
6.7
2.1
23.4
35-54
83.8
74.4
6.8
2.6
5.5
2.7
14.7
55-61
19.3
70.4
9.9
7.1
7.0
4.3
12.8
62-64
6.5
61.9
12.9
14.2
6.9
5.9
14.1
65+
33.8
35.3
30.3
96.1
9.7
6.4
0.8
Total
282.1
64.1%
9.2%
13.5%
11.2%
3.4%
14.6%
Source: CRS analysis of data from the March 2002 Current Population Survey (CPS).
a People may have had more than one source of health insurance over the course of the year.
b Group health insurance through employer or union.
c Nonmilitary. Includes State Children’s Health Insurance Program (SCHIP) and other state programs for
low-income individuals.
Other Demographic Characteristics. Table 2 shows the rate of health
insurance coverage by type of insurance and selected demographic characteristics — race,
family type, region, poverty level and citizenship — for people under age 65. In 2001,
whites were least likely to be uninsured (12%), while Hispanics were most likely (35%).
The rate of employment-based health coverage was highest among whites (76%), and the
rate of public coverage1 was highest among blacks (24%).
People in male-headed or two-parent families with children were less likely to be
uninsured (13%) than those in female-headed families with children (21%) or in families
with no children (19%). The sources of coverage were quite different for male-present
(one or two parents) and female-headed (single parent) families with children: Coverage
was employment based for 74% of male-present families compared to 45% of female-
headed families; 10% of male-present families had public coverage compared to 36% of
female-headed families.
People were less likely to be uninsured if they lived in the Midwest (12%) or the
Northeast (14%), than if they lived in the South (19%) or West (19%). More than 70%
of those living in the Northeast and Midwest had employment-based health insurance
compared to 65% in the South and 63% in the West. Among individuals with incomes
at least two times the poverty level, 11% went without health insurance compared to 34%
of the poor (i.e., those with incomes below the poverty level). Only 21% of the poor
received health coverage through employment, and 44% had public coverage. More than
1 Includes Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), or some
other program for low-income individuals. Excludes military and veterans coverage.

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80% of people with incomes at least two times the poverty level were covered through an
employer, and only 5% had public coverage.
Non-citizens were more likely to be uninsured that people born with U.S. citizenship
(i.e., “native”) — 44% versus 14%, respectively. Non-citizens accounted for 8% of the
population under 65, but were 21% of the uninsured. About 44% of non-citizens were
covered through employment, compared to 70% of citizens.
Table 2. Health Insurance Coverage by Type of Insurance and
Demographic Characteristics for People Under Age 65, 2001
Type of insurancea
Population
Employment
(in millions)
basedb
Publicc
Otherd
Uninsured
Race/ethnicity
White
166.9
75.6%
9.3%
10.3%
11.6%
Black
31.9
56.5
23.9
7.1
20.1
Hispanic
35.5
44.8
19.4
5.1
34.7
Other
14.0
62.1
13.0
10.8
20.5
Family type
Female-headed
29.6
45.3
36.3
4.8
20.5
with children
Two parent or
119.5
73.9
10.3
9.0
13.1
male-headed
w/children
No children
99.2
67.6
8.9
10.7
19.4
Region
Northeast
46.1
71.8
13.6
6.5
13.8
Midwest
55.9
74.6
11.1
8.3
12.2
South
88.5
65.0
13.3
10.2
18.8
West
57.8
63.1
13.3
10.6
19.3
Poverty levele
Less than 100%
29.5
20.6
44.0
6.7
33.9
of poverty
100%-149%
20.9
37.8
29.9
8.7
30.6
of poverty
150%-199%
21.7
52.8
19.0
9.8
25.8
of poverty
200%+
175.6
81.5
4.7
9.6
10.7
of poverty
Citizenship
Native
219.2
70.2
13.3
9.5
13.8
Naturalized
9.6
65.8
8.8
9.7
21.0
Non-Citizens
19.5
43.5
9.7
5.7
44.3
Total
248.3
68.0%
12.8%
9.2%
16.5%
Source: CRS analysis of data from the March 2002 CPS.
a People may have more than one source of coverage; percentages may total to more than 100.
b Group health insurance through employer or union.
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 Private nongroup health insurance, veterans coverage, or military health care.
e In 2001, the weighted average poverty threshold for a family of four was $18,104. Approximately 607,000
children are excluded from CPS-based poverty analyses because they are in unrelated subfamilies.

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Employment Characteristics. Following 2 years of significant increases in
employment-based coverage, the prevalence of job-related health insurance fell in 2001
to 68%. Table 3 shows the rate of health insurance coverage by employment
characteristics for people under age 65 who were workers or their dependents. In 2001,
only about 8% of workers and dependents of workers in large firms (1,000 or more
employees) were uninsured compared to 33% in small firms (less than 10 employees).
People who reported working in small firms and their dependents accounted for 14% of
the under 65 population but 28% of the uninsured. Insurance coverage varied according
to industry, as well. Agriculture and personal services had the highest proportion of
uninsured workers and dependents — more than 30%; only 3% of those in public
administration were uninsured. Among workers, 84% of those employed full time, full
year had health insurance, most often through their own employment (78%). In 2001,
nearly one-third of workers with less than full time, full year employment were uninsured.
Table 3. Health Insurance Coverage by Employment
Characteristicsa for People Under Age 65, 2001
Type of insuranceb
Population
From
From
(in millions)
own jobc
other’s jobc
Otherd
Uninsured
Firm sizee
Under 10
34.2
20.5%
21.5%
30.5%
33.3%
10-24
18.3
31.0
28.1
20.3
27.3
25-99
27.0
37.9
36.2
16.4
18.0
100-499
30.0
40.8
42.9
14.0
11.6
500-999
12.8
42.9
43.2
12.4
10.2
1,000 +
92.2
42.5
45.5
14.4
8.2
Industrye
Agriculture
4.7
16.9%
18.3%
32.0%
38.3%
Personal services
5.5
25.8
20.8
25.7
33.6
Construction
17.0
26.6
31.4
18.4
29.4
Retail trade
28.6
30.7
26.6
23.1
26.4
Entertainment
3.3
36.5
27.9
21.0
22.3
Business services
14.7
32.6
32.7
21.3
21.8
Wholesale trade
8.8
38.4
44.5
12.3
12.6
Nondurable goods
14.2
39.9
44.8
12.8
11.3
Mining
1.2
35.3
45.5
17.0
11.2
Transportation
18.5
39.7
45.6
12.6
11.2
Professional services
49.6
43.3
41.1
16.4
9.9
Durable goods
22.0
41.4
46.6
11.2
9.4
Finance/insurance
13.4
42.8
43.7
13.4
8.9
Public administration
13.2
39.9
47.0
25.5
3.4

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Type of insuranceb
Population
From
From
(in millions)
own jobc
other’s jobc
Otherd
Uninsured
Labor force attachment of policyholder or, if no insurance, working family membera
Workers
Full time, full year
85.3
78.2
6.6
10.6
16.0
Full time, part year
15.1
56.5
5.6
18.4
30.7
Part time, full year
6.2
46.9
6.6
24.0
33.3
Part time, part year
5.1
33.1
5.2
32.9
38.3
Workers’ Dependents
Full time, full year
84.8
0.0
77.5
18.2
10.4
Full time, part year
11.0
0.0
57.4
38.2
13.7
Part time, full year
4.3
0.0
53.1
35.4
16.5
Part time, part year
2.8
0.0
40.6
54.4
12.2
Not working
26.3
15.2f
9.8
54.3
27.7
Coverage outside home
7.4
8.0
100.0
16.5
0.0
Total
248.3
34.0%
37.3%
21.4%
16.5%
Source: CRS analysis of data from the March 2002 CPS.
a The employment characteristics are those of the policyholder. In families without private coverage,
“workers” are the family head or, if the head is not employed, the spouse. For “dependents,” the
employment characteristics are those of the person providing dependent coverage or, if the dependent
has no private health insurance, to the head of household or spouse.
b People may have more than one source of health insurance during the year.
c Group health insurance through current or former employer or union.
d Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), nongroup health insurance,
veterans coverage, and other government coverage.
e For persons who worked and their dependents.
f Nearly 90% 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 for 2001.
Approximately 17% of the uninsured were 19 to 24 years old, even though this age group
represents less than 9% of the under 65 population.
Our report for the year 2000 noted that for the first time since 1994, when CRS first
began this annual analysis, the percentage of the uninsured who were white fell below
50% — to 49%. In 2001, this percentage dropped again, to 47%, even though whites
make up two-thirds (67%) of the under 65 population.
More than half (55%) of the uninsured were full time, full year workers or their
dependents. Approximately 18% had no attachment to the labor force. Approximately
three-quarters of the uninsured were above the poverty level. Even though the poor
accounted for only 12% of the under 65 population, they represented 25% of the
uninsured. For the first time since 1994, more than one-quarter of the uninsured were not
native-born citizens (i.e., they were either not citizens or were naturalized citizens).

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