Health Insurance: Uninsured by State, 2001

Health Insurance: Uninsured by State, 2001

Order Code 96-979 EPW
Updated November 19, 2002
CRS Report for Congress
Received through the CRS Web
Health Insurance: Uninsured by State, 2001
Paulette C. Morgan
Analyst in Social Legislation
Domestic Science Policy Division
Summary
An estimated 14.6% of the U.S. population lacked health insurance coverage in
2001, up from 14.2% in 2000. When examined by state, estimates of the percent
uninsured ranged from a low of 7.5% in Iowa to a high of 23.5% in Texas. Generally,
states in the Midwest and New England have lower rates of uninsured, while states in
the Southwestern and Southern portions of the nation have higher shares of their
populations without coverage.
These state-level estimates are based on the March 2002 Current Population Survey
(CPS), and must be interpreted with caution because they are based on a survey sample.
When sampling variation is taken into account, to allow one to say with 90% reliability
that the percent uninsured in the state lies between specified low and high estimates, the
uninsured rate in 3 states is not different statistically from the uninsured rate nationwide.
The uninsured rate is statistically lower than the national rate in 31 states and the District
of Columbia, and statistically higher in the remaining 16 states.
State-level analysis is only one way to examine data about health insurance
coverage. Some factors related to the percent of a state’s population that is uninsured
may be affected by the state, such as eligibility criteria for the state’s Medicaid and State
Children’s Health Insurance programs or other programs for those lacking health
insurance. Other factors may be beyond the state’s direct control, such as the
willingness of employers to offer coverage and the financial resources of the state’s
population to purchase coverage.
This report will be updated annually, when new data become available. For related
information, see CRS Report 96-891, Health Insurance Coverage: Characteristics of
Insured and Uninsured in 2001, and CRS Report 97-310, Health Insurance: Uninsured
Children by State, 1999-2001.
Congressional Research Service ˜ The Library of Congress

CRS-2
Estimates of The Uninsured by State
An estimated 14.6% of the U.S. population lack health insurance coverage in 2001,
up from 14.2% in 2000.1 Table 1 shows that the estimated percent of each state’s
population that lacked health insurance2 coverage in 2001 ranged from a low of 7.5% in
Iowa to a high of 23.5% in Texas. Thirteen states3 had estimated uninsured rates less than
10% and 2 states4 had estimated rates greater than 20%. Generally, states with the lowest
rates of uninsurance were located in the Midwest and Northeast; states with the highest
rates were in the Southwest and South (Figure 1).
These estimates of the percent of the state population without health insurance
coverage are based on data from the March 2002 Current Population Survey (CPS). The
CPS is representative of the civilian, noninstitutionalized population, and is designed to
produce reliable estimates at the national, regional and state level.
The small sample sizes available from the CPS for many states make it prudent to
consider state-level estimates in terms of a range of values. This range is based on
sampling theory, and takes into account the size of the sample. Table 1 shows the best
point estimates, or single values, for the numbers of people covered and not covered by
health insurance, and the percent uninsured by state.5 The table also reports a range in
values for these numbers and percentages. The size of the range depends primarily upon
the sample size. Table 1 shows ranges based on a 90% confidence interval. A 90%
confidence interval means that given repeated sampling of health insurance coverage in
a state, 9 out of 10 times, the estimate of the percent uninsured (or number covered or not
covered) will lie within the range set by the low and high estimates. For example, if one
surveys people in Iowa about health insurance coverage, in 9 out of 10 sample surveys,
on average, the percent uninsured in Iowa will be between 6.8% and 8.2%.6
Because of the uncertainty about state-level estimates of the percent uninsured, a
more statistically conservative comparison across states takes ranges of values into
1 This report uses population estimates based on the 2000 Census instead of 1990 Census. The
CPS for 2001 also includes an expanded sample of households. Due to these changes, rates of
uninsured in this report are not comparable to any previous version of this report.
2 Health insurance includes, but is not limited to: Medicare; Medicaid; S-CHIP; TRICARE or the
Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); the Civilian
Health and Medical Program of the Department of Veteran’s Affairs (CHAMPVA); Veteran’s
Administration health care; military health care; other government provided health care;
employer/union-provided insurance; and privately purchased insurance.
3 Iowa (7.5%), Rhode Island (7.7%), Wisconsin (7.7%), Minnesota (8.0%), Massachusetts
(8.2%), Delaware (9.2%), Pennsylvania (9.2%), South Dakota (9.3%), New Hampshire (9.4%),
Nebraska (9.5%), Hawaii (9.6%), North Dakota (9.6%), and Vermont (9.6%).
4 New Mexico (20.7%), and Texas (23.5%).
5 Table 1 shows states sorted by the percent uninsured. Table 2 reports the same data but sorts
states alphabetically.
6 Note that there is no way to determine if the results for Iowa in Table 1 are the 1 time out of
10 that a different result is obtained, where the real percent uninsured is outside the confidence
interval (i.e., less than 6.8% or greater than 8.2%).

CRS-3
account. This is done in Figure 2, which groups states according to differences from the
nationwide percent uninsured, considering the estimated ranges in the percent uninsured
by state. When statistical variation is taken into account, 3 states have percents uninsured
that are not statistically different from the nationwide rate of 14.6%. (The nationwide
percent uninsured has a range in estimates of between 14.4% and 14.8%.) These 3 states
have percents uninsured ranging from a low point estimate of 13.6% in Montana (with a
range in estimates between 12.6% and 14.6%) to a high point estimate of 14.8% in Utah
(with a range in estimates between 14.0% and 15.6%.) Thirty-one states and the District
of Columbia have percents uninsured that are statistically lower than the nationwide rate.
These states include all states in New England and the Midwest, a few states in the eastern
United States, as well as Washington, Oregon and Hawaii. The remaining 16 states,
arrayed across the South and Southwest from Mississippi to California, as well as Florida,
Georgia, Idaho, Wyoming, Alaska and New York, have uninsured rates that are
statistically higher than the nationwide rate.
Reasons for Differences in the Percent Uninsured
Figures 1 and 2 indicate that residents of the Southern and Southwestern United
States are more likely to lack health insurance and residents of the Midwest and New
England are more likely to be covered. Various state characteristics may account for these
differences. Nationwide, the percent uninsured is related to employment by industry, with
workers in manufacturing of durable goods, professional services, finance/insurance, and
public administration industries most often covered by health insurance and those
employed in agriculture, and personal services least often covered. Employees who work
for large firms, and their dependents, are more likely to be covered than those who work
for small firms. Union members are more likely to be covered. The prevalence of
particular industries, firm sizes, or unionization may account for some of the regional or
state variation in percents uninsured.7
Some factors related to the percent of a state’s population that is uninsured may be
affected by state’s policies, such as eligibility criteria for the state’s Medicaid program or
the State Children’s Health Insurance Program. Other factors may be beyond the state’s
direct control, such as the willingness of employers to offer coverage and the financial
resources of the state’s population to purchase coverage. Only Hawaii has implemented
state legislation mandating that an employer offer coverage, which is augmented with a
health insurance program for the unemployed.8
7 For additional information, see CRS Report 96-891, Health Insurance Coverage:
Characteristics of the Insured and Uninsured Populations in 2001, by Chris Peterson.
8 Hawaii received a congressional exemption from the Federal Employee Retirement and Income
Security Act of 1974 (ERISA) to permit the employer mandate. No other state has received a
similar exemption.

CRS-4
Table 1. Number of People Covered and Not Covered by Health Insurance,
and Percent Not Covered, By State, 2001
Sorted by Percent Uninsured (numbers in thousands)
Number covered
Number not covered
Percent not covered
Point
Range
Point
Range
Point
Range
estimate
Low
High
estimate
Low
High
estimate
Low
High
Iowa
2,645
2,581
2,709
216
198
234
7.5%
*
6.8%
8.2%
Rhode Island
963
942
984
80
73
87
7.7%
*
7.2%
8.2%
Wisconsin
4,927
4,817
5,037
409
378
440
7.7%
*
7.0%
8.4%
Minnesota
4,530
4,426
4,634
392
361
423
8.0%
*
7.3%
8.7%
Massachusetts
5,802
5,677
5,927
520
482
558
8.2%
*
7.7%
8.7%
Delaware
719
699
739
73
66
80
9.2%
*
8.5%
9.9%
Pennsylvania
10,983
10,805
11,161
1,119
1,061
1,177
9.2%
*
8.7%
9.7%
South Dakota
670
654
686
69
64
74
9.3%
*
8.6%
10.0%
New Hampshire
1,139
1,113
1,165
119
111
127
9.4%
*
8.7%
10.1%
Nebraska
1,523
1,484
1,562
160
147
173
9.5%
*
8.8%
10.2%
Hawaii
1,096
1,068
1,124
117
107
127
9.6%
*
8.9%
10.3%
North Dakota
561
546
576
60
55
65
9.6%
*
8.9%
10.3%
Vermont
549
536
562
58
53
63
9.6%
*
8.9%
10.3%
Connecticut
3,047
2,976
3,118
346
323
369
10.2%
*
9.5%
10.9%
Missouri
4,960
4,842
5,078
565
524
606
10.2%
*
9.5%
10.9%
Maine
1,147
1,121
1,173
132
124
140
10.3%
*
9.6%
11.0%
Michigan
8,864
8,703
9,025
1,028
972
1,084
10.4%
*
9.9%
10.9%
Virginia
6,331
6,176
6,486
774
720
828
10.9%
*
10.2%
11.6%
Ohio
9,943
9,767
10,119
1,248
1,184
1,312
11.2%
*
10.7%
11.7%
Tennessee
5,042
4,904
5,180
640
591
689
11.3%
*
10.5%
12.1%
Kansas
2,341
2,283
2,399
301
280
322
11.4%
*
10.6%
12.2%
Indiana
5,322
5,204
5,440
714
670
758
11.8%
*
11.1%
12.5%
Kentucky
3,505
3,413
3,597
492
457
527
12.3%
*
11.5%
13.1%
Maryland
4,673
4,561
4,785
653
610
696
12.3%
*
11.5%
13.1%
South Carolina
3,517
3,427
3,607
493
458
528
12.3%
*
11.5%
13.1%
D.C.
484
469
499
70
65
75
12.7%
*
11.7%
13.7%
Oregon
3,018
2,939
3,097
443
413
473
12.8%
*
12.0%
13.6%
Alabama
3,815
3,715
3,915
573
534
612
13.1%
*
12.3%
13.9%
New Jersey
7,361
7,221
7,501
1,109
1,055
1,163
13.1%
*
12.4%
13.8%
Washington
5,151
5,018
5,284
780
727
833
13.1%
*
12.3%
13.9%
West Virginia
1,539
1,501
1,577
234
219
249
13.2%
*
12.4%
14.0%
Illinois
10,655
10,471
10,839
1,676
1,602
1,750
13.6%
*
13.1%
14.1%
Montana
771
748
794
121
111
131
13.6%
12.6%
14.6%
North Carolina
6,932
6,782
7,082
1,167
1,104
1,230
14.4%
13.7%
15.1%
Utah
1,927
1,876
1,978
335
314
356
14.8%
14.0%
15.6%
New York
15,911
15,696
16,126
2,916
2,822
3,010
15.5% **
15.0%
16.0%
Colorado
3,723
3,636
3,810
687
649
725
15.6% **
14.8%
16.4%
Alaska
534
521
547
100
93
107
15.7% **
14.9%
16.5%
Wyoming
411
399
423
78
73
83
15.9% **
14.9%
16.9%
Idaho
1,105
1,074
1,136
210
197
223
16.0% **
15.0%
17.0%
Arkansas
2,229
2,165
2,293
428
400
456
16.1% **
15.1%
17.1%
Nevada
1,791
1,747
1,835
344
324
364
16.1% **
15.3%
16.9%
Mississippi
2,341
2,270
2,412
459
428
490
16.4% **
15.4%
17.4%
Georgia
6,912
6,729
7,095
1,376
1,294
1,458
16.6% **
15.6%
17.6%
Florida
13,491
13,279
13,703
2,856
2,757
2,955
17.5% **
17.0%
18.0%
Arizona
4,365
4,238
4,492
950
891
1,009
17.9% **
16.9%
18.9%
Oklahoma
2,762
2,686
2,838
620
584
656
18.3% **
17.3%
19.3%
Louisiana
3,544
3,440
3,648
845
794
896
19.3% **
18.3%
20.3%
California
27,770
27,420
28,120
6,718
6,539
6,897
19.5% **
19.0%
20.0%
New Mexico
1,431
1,383
1,479
373
348
398
20.7% **
19.5%
21.9%
Texas
16,105
15,843
16,367
4,960
4,812
5,108
23.5% **
22.8%
24.2%
U.S.
240,875
n/a
n/a
41,207
40,881
41,533
14.6%
14.4%
14.8%
Source: Bureau of the Census, based on the March 2002 Current Population Survey; ranges computed by the Congressional Research
Service.
Notes: * indicates percent uninsured is statistically lower than the national rate; ** indicates percent uninsured is statistically higher
than the national rate. Range represents low and high estimates given a 90% confidence interval. n/a indicates not applicable.

CRS-5
Table 2. Number of People Covered and Not Covered by Health Insurance,
and Percent Not Covered, By State, 2001
Alphabetical by State (numbers in thousands)
Number covered
Number not covered
Percent not covered
Point
Range
Point
Range
Point
Range
estimate
Low
High
estimate
Low
High
estimate
Low
High
Alabama
3,815
3,715
3,915
573
534
612
13.1%
*
12.3%
13.9%
Alaska
534
521
547
100
93
107
15.7% **
14.9%
16.5%
Arizona
4,365
4,238
4,492
950
891
1,009
17.9% **
16.9%
18.9%
Arkansas
2,229
2,165
2,293
428
400
456
16.1% **
15.1%
17.1%
California
27,770
27,420
28,120
6,718
6,539
6,897
19.5% **
19.0%
20.0%
Colorado
3,723
3,636
3,810
687
649
725
15.6% **
14.8%
16.4%
Connecticut
3,047
2,976
3,118
346
323
369
10.2%
*
9.5%
10.9%
Delaware
719
699
739
73
66
80
9.2%
*
8.5%
9.9%
D.C.
484
469
499
70
65
75
12.7%
*
11.7%
13.7%
Florida
13,491
13,279
13,703
2,856
2,757
2,955
17.5% **
17.0%
18.0%
Georgia
6,912
6,729
7,095
1,376
1,294
1,458
16.6% **
15.6%
17.6%
Hawaii
1,096
1,068
1,124
117
107
127
9.6%
*
8.9%
10.3%
Idaho
1,105
1,074
1,136
210
197
223
16.0% **
15.0%
17.0%
Illinois
10,655
10,471
10,839
1,676
1,602
1,750
13.6%
*
13.1%
14.1%
Indiana
5,322
5,204
5,440
714
670
758
11.8%
*
11.1%
12.5%
Iowa
2,645
2,581
2,709
216
198
234
7.5%
*
6.8%
8.2%
Kansas
2,341
2,283
2,399
301
280
322
11.4%
*
10.6%
12.2%
Kentucky
3,505
3,413
3,597
492
457
527
12.3%
*
11.5%
13.1%
Louisiana
3,544
3,440
3,648
845
794
896
19.3% **
18.3%
20.3%
Maine
1,147
1,121
1,173
132
124
140
10.3%
*
9.6%
11.0%
Maryland
4,673
4,561
4,785
653
610
696
12.3%
*
11.5%
13.1%
Massachusetts
5,802
5,677
5,927
520
482
558
8.2%
*
7.7%
8.7%
Michigan
8,864
8,703
9,025
1,028
972
1,084
10.4%
*
9.9%
10.9%
Minnesota
4,530
4,426
4,634
392
361
423
8.0%
*
7.3%
8.7%
Mississippi
2,341
2,270
2,412
459
428
490
16.4% **
15.4%
17.4%
Missouri
4,960
4,842
5,078
565
524
606
10.2%
*
9.5%
10.9%
Montana
771
748
794
121
111
131
13.6%
12.6%
14.6%
Nebraska
1,523
1,484
1,562
160
147
173
9.5%
*
8.8%
10.2%
Nevada
1,791
1,747
1,835
344
324
364
16.1% **
15.3%
16.9%
New Hampshire
1,139
1,113
1,165
119
111
127
9.4%
*
8.7%
10.1%
New Jersey
7,361
7,221
7,501
1,109
1,055
1,163
13.1%
*
12.4%
13.8%
New Mexico
1,431
1,383
1,479
373
348
398
20.7% **
19.5%
21.9%
New York
15,911
15,696
16,126
2,916
2,822
3,010
15.5% **
15.0%
16.0%
North Carolina
6,932
6,782
7,082
1,167
1,104
1,230
14.4%
13.7%
15.1%
North Dakota
561
546
576
60
55
65
9.6%
*
8.9%
10.3%
Ohio
9,943
9,767
10,119
1,248
1,184
1,312
11.2%
*
10.7%
11.7%
Oklahoma
2,762
2,686
2,838
620
584
656
18.3% **
17.3%
19.3%
Oregon
3,018
2,939
3,097
443
413
473
12.8%
*
12.0%
13.6%
Pennsylvania
10,983
10,805
11,161
1,119
1,061
1,177
9.2%
*
8.7%
9.7%
Rhode Island
963
942
984
80
73
87
7.7%
*
7.2%
8.2%
South Carolina
3,517
3,427
3,607
493
458
528
12.3%
*
11.5%
13.1%
South Dakota
670
654
686
69
64
74
9.3%
*
8.6%
10.0%
Tennessee
5,042
4,904
5,180
640
591
689
11.3%
*
10.5%
12.1%
Texas
16,105
15,843
16,367
4,960
4,812
5,108
23.5% **
22.8%
24.2%
Utah
1,927
1,876
1,978
335
314
356
14.8%
14.0%
15.6%
Vermont
549
536
562
58
53
63
9.6%
*
8.9%
10.3%
Virginia
6,331
6,176
6,486
774
720
828
10.9%
*
10.2%
11.6%
Washington
5,151
5,018
5,284
780
727
833
13.1%
*
12.3%
13.9%
West Virginia
1,539
1,501
1,577
234
219
249
13.2%
*
12.4%
14.0%
Wisconsin
4,927
4,817
5,037
409
378
440
7.7%
*
7.0%
8.4%
Wyoming
411
399
423
78
73
83
15.9% **
14.9%
16.9%
U.S.
240,875
n/a
n/a
41,207
40,881
41,533
14.6%
14.4%
14.8%
Source: Bureau of the Census, based on the March 2002 Current Population Survey; ranges computed by the Congressional Research
Service.
Note: * indicates percent uninsured is statistically lower than the national rate; ** indicates percent uninsured is statistically higher
than the national rate. Range represents low and high estimates given a 90% confidence interval. n/a indicates not applicable.

CRS-6
Figure 1. Percent Uninsured by State, 2001
US average is 14.6%
Percent uninsured
20% or more
(2)
15.0 to 19.9%
(14)
10.0 to 14.9%
(22)
Less than 10.0% (13)
Figure 2. Percent Uninsured by State, 2001
Accounting for Statistical Variation in Estimates
Percent uninsured
Greater than US average (16)
Same as US average
(3)
Less than US average
(32)