Which Americans Are Uninsured?

The Uninsured: A Primer
Key Facts About Americans Without Health Insurance
The Henry J. Kaiser Family Foundation; 36 pages

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Young and Uninsured: Cartoonist Julia Wertz

The Gist:
As members of Congress vote on controversial health-care-reform legislation, the Henry J. Kaiser Family Foundation has analyzed census data to provide a closer look at the people without health insurance in the U.S. Its report, focused on people younger than age 65, found 45.7 million "nonelderly" uninsured people in the U.S. last year (including the elderly, the number of uninsured was 46.3 million). Low-income adults without dependent children — who generally do not qualify for government programs like Medicaid — were hit hardest. Despite heated rhetoric on the issue, immigrants are not driving the problem; 80% of the uninsured under age 65 are native-born or naturalized citizens. The uncompensated cost of providing health care to the uninsured last year was $57 billion, three-quarters of which was picked up by the Federal Government. (Watch TIME's video "Young and Uninsured: Cartoonist Julia Wertz.")

Highlight Reel:
1. One in six are uninsured: The ranks of the uninsured in America under age 65 grew by 700,000 last year, largely because of the layoffs and wage slashes that accompanied the weak economy. Two million people lost their employer-sponsored health coverage in 2008 alone. Since 2000, the total number of uninsured has risen every year but one.

2. Most uninsured Americans work: Of those under age 65 without insurance, 8 in 10 are members of working families. Only 19% are in families with no one working. However, 62% of the uninsured have no education beyond high school, limiting their ability to boost their incomes or advance to jobs that may offer health care. The uninsured were three times more likely to have trouble meeting basic monthly expenses like rent and food.
(Read "The Democrats' Phantom Fix on Health Care.")

3. Unsurprisingly, the uninsured are in worse health: Of those without health insurance, 11% reported being in fair or poor health, compared with 5% with private coverage. Nearly a quarter of the uninsured say they've forgone medical care in the past year due to its cost, compared with 4% who receive private care. As a result, the uninsured are more likely to be hospitalized for avoidable health problems.

4. Government programs are making a difference for children: Despite overall increases, the number of uninsured children last year fell by 800,000, to 8.1 million, thanks to expansions in Medicaid and state programs covering minors. (The total in 2006 was 9.4 million.)

5. Young adults with no children are especially vulnerable: Programs such as Medicaid and Medicare insure millions of parents, children and disabled people. But low earners without dependent children are offered few resources when it comes to health insurance; they comprise 58% of uninsured Americans as a result. At 30%, those ages 19 to 29 have the highest uninsured rate.

6. Immigrants represent a minority of the uninsured: Eighty percent of those without health insurance are native-born or naturalized citizens. However, immigrants are more likely to be uninsured than legal residents. Racial minorities are also disproportionately represented; about one-third of Hispanics and one-fifth of blacks go without insurance, compared with 13% of whites.
(Read "How Valid Is the Insurers' Attack on Health Reform?")

The Lowdown:
Most people know that millions of Americans lack health insurance, but this report helps give that enormous group a human face. That many unemployed workers lack health insurance is not a surprise, but many of us may not realize that so many working people do as well — a troubling fact that lends credence to the reform efforts under way on Capitol Hill. Highlighting the plight of childless uninsured adults is also a welcome counterbalance to media coverage of the issue, which often focuses on uninsured children and families. Amid the grim statistics, the foundation mentions a bright spot: the fact that recent expansion of children's health-care programs has helped lower the number of uninsured children. The notion that young people should have access to adequate health care has long drawn bipartisan political support; reaching that same goal with adults has, until now, proven far more difficult to accomplish.

The Verdict: Skim.

Watch TIME's video "The Story of an Uninsured Woman."

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