1. Most children and families have health care coverage.
There are two primary sources of health coverage in the United States: employer coverage and the public programs, Medicaid and CHIP. In 2011, 92.5% of children and almost 79% of adults had health care coverage, most through an employer. At the same time, 5.5 million children under age 18 and 40.5 million adults under age 65 were uninsured. 1
2. The number of uninsured children has continued to decline, while losses in adult coverage persist.
As of 2011, 5.5 million children under age 18 and 40.5 million adults had no health care coverage.2 For children, this number represents a little more than a 13% decline from 2009-2011; for adults, however, the number of uninsured has risen by almost 4% over the over the same three-year period. The number of uninsured in the country is the function of a number of factors, including the availability and cost of employer coverage, access and eligibility for public programs, and a family’s ability to pay for either form of coverage.
3. Health coverage is vital to healthy development.
Children who are uninsured are more likely to go without immunizations and miss school because of untreated illness. Due to their decreased access to primary and preventive care, they are also more likely to end up seeking care in emergency rooms.3 Coverage is important to adults as well, helping them get timely medical care and improving their long-term health outcomes.4
4. Families are discovering it harder to find and pay for health coverage.
Rapidly rising health care costs and declines in the number of families able to secure coverage through their jobs has made it more difficult for families to afford coverage. In 2012, the cost of health insurance premiums for family coverage rose 4% from the previous year. Workers contributed, on average, 28% of the premium for family coverage, although workers employed at small firms, on average, contributed significantly more for family coverage than workers in large firms do (35% vs 25%).
Since 1999, the percentage of employers that offer health coverage has fluctuated between 59% and 69%, with smaller firms, firms that employ more low-wage workers, and those with a greater number of part-time staff less likely to offer coverage. Employers often cite the high cost of health insurance as the reason they do not offer coverage.5
5. Public programs play a critical role, especially for children.
The number of uninsured Americans declined slightly to 46.4 million in 2011, yet the percent who are uninsured (15.1%) is the same as it was in 2009. However, public health insurance programs have helped stem the tide of rising uninsured rates among children. In 2011, 27.5 million or more than 37% of children were insured by public programs, including Medicaid and CHIP, an increase that more than offset the loss of private coverage.6 In addition, the potential exists to cover more uninsured children, as close to 70% are eligible for Medicaid or CHIP.7
Fewer adults have public health insurance coverage, due in large part to their limited eligibility. In 2011, only about 14% of adults and 15% of parents were covered by public programs.8 However, the Affordable Care Act builds upon the success in covering children by extending Medicaid to more uninsured people.
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3. P. Newacheck, J. Stoddard, D. Hughes, & M. Pearl, “Health Insurance and Access to Primary Care for Children,” New England Journal of Medicine, 338: 513-519 (1998); L. Olson, S. Tang, & P. Newacheck, “Children in the United States with Discontinuous Health Insurance,” New England Journal of Medicine, 353: 382-391 (2005); G. Stevens, M. Seid, & N. Halfon, “Enrolling Vulnerable, Uninsured, but Eligible Children in Public Health Insurance: Association with Health Status and Primary Care Access,” Pediatrics, 117: 751-759 (2006); W. Johnson & M. Rimsza, “The Effects of Access to Pediatric Care and Insurance Coverage on Emergency Department Utilization,” Pediatrics, 113: 483-487 (2004); and Institute of Medicine (2002), “Health Insurance is a Family Matter,” Washington, DC: The National Academies Press.
4. R. B. Bovbjerg & J. Hadley, “Health Policy Briefs: Why Health Insurance Is Important,” The Urban Institute, (November 2007); J. Hadley, “Sicker and Poorer,” Medical Research and Review, 60(2): 3S-75S (2002).