HEALTH INSURANCE COVERAGE OF WORKING-AGE ADULTS. One-Third of Working-Age Adults Were Currently Uninsured or Had a Recent Gap* 164 million adults age

HEALTH INSURANCE COVERAGEOF WORKING-AGE ADULTS

One-Third of Working-Age Adults Were Currently Uninsured or Had a Recent Gap*

CurrentlyUninsured

19%

Continuously Insured

68%

Recent Gap*13%

164 million adults age 18-64

* Recent gap = insured when surveyed but had a period in past 2 years without coverage

Low-Income, Working-Age Adults Were More Likely to Be Uninsured or to Have Had a Recent Gap*

CurrentlyUninsured

8%

Recent Gap11%

ContinuouslyInsured

81%

ContinuouslyInsured

48%

Recent Gap17%

CurrentlyUninsured

36%


<200% of poverty 200%+ of poverty

Two-Thirds of Adults with a Time UninsuredWere Uninsured for One Year or More

4 to 11 Months21%

12 to 23 Months20%

2 Years or More44% Up to 3 Months

15%

52 million adults age 18-64currently uninsured or recent gap

Cost and Lack of Employer Benefits Were theMain Reasons for Not Having Insurance

51%

25%

11%4%

0%

20%

40%

60%

Can't Afford It Lost Job or NoBenefits

Don't Want It Poor Health,Refused Insurance

31 million currently uninsured adults age 18-64

Reasons for not having health insurance

Over Half of Adults in Low-Wage, Working Families Were Uninsured Sometime in the Past Two Years

39%

14%

20%

17%

4% 2%9%

6%0%

20%

40%

60%

$20,000 or less $20,001-35,000 $35,001-60,000 Above $60,000

128 million adults age 18-64 in familieswith a FT or PT worker

Currently Uninsured Recent Gap59%

31%

13%8%

Note: In 1996, 200% of poverty was about $21,000 for a family of two and $25,000 for a family of three

Most Uninsured Adults Were Working Full-Time or Married to a Full-Time Worker

Only Part-Time Workers

16%

Unemployed15%

Other*12%

Full-Time Worker

57%

52 million adults age 18-64 currently uninsured or recent gap

* Respondent or spouse is disabled, a student, or a retiree, and neither is a full- or part-time worker

Adults in Low-Wage, Working Families Were Uninsured for Longer Periods of Time

26%21%

22%21%

17%

51%34%

7%0%

25%

50%

75%

100%

<200% of Poverty 200%+ of Poverty

24 Months+

12-23 Months

4-11 Months

1-3 Months

38 million adults age 18-64 in working familieswith a time uninsured in past 2 years

Period of TimeWithout Coverage

Part-Time Worker and Unemployed Families Were at High Risk of Being Uninsured

50%

18%

50%

12%16%

14%14%

13% 14%

8%

0%

20%

40%

60%

80%

Total Full-Time Part-Time CurrentlyUnemployed

Other*

Adults age 18-64 by family work status

Currently Uninsured Recent Gap

30% 28%

63% 64%

26%

Working

* Respondent or spouse is disabled, a student, or a retiree, and neither is a full- or part-time worker

Insurance Coverage Was Often Unstablefor Adults Under Age 65

33%34%

42%

34%

0%

20%

40%

60%

Insured Medicaid Employer Other Private

132 million currently insured adults age 18-64

Percent in current plan less than 2 years

Reasons for Changes in Health Plans

34%

14% 16%21%

0%

20%

40%

60%

Changed or LostJob

EmployerChanged Plans

Lost or ChangedEligibility Status

Found a Better orCheaper Plan

Reasons for plan change for adults who changed plans in the past 2 years

ACCESS TO HEALTH CARE

Two in Five Uninsured Adults Went Without Needed Care in the Past Year

11%6%7%

33%

21%21%

42%

24%30%

0%

20%

40%

60%

Did Not Get NeededCare

Did Not Fill Prescription Either Problem

Continuously Insured Recent Gap Currently Uninsured


Half of Uninsured Adults Had Access Difficultiesand Postponed Care Due to Costs

12%17%

10%

40%

19%27%

55%

42%

51%

0%

20%

40%

60%

Difficult to Get CareWhen Needed

No Physician Visit inPast Year

Postponed Care Due toCosts in Past Year



Low-Income Uninsured Adults Were atHigh Risk of Access Problems

19%

8%

38%

28%

46%

27%

0%

20%

40%

60%

Below 200% Poverty 200% Poverty or More


Percent not getting needed care or prescription in past year

Adults age 18-64

Going Without Needed Care Had Consequences

42%45%

68%74%

0%

20%

40%

60%

80%

Problem CausedPain or

Difficulties

ConsequencesWere Serious

Still HaveProblem

Went WithoutCare More than

Once

21 million adults age 18-64 who had a time they didn't get need care

PROBLEMS PAYING MEDICAL BILLS

Uninsured Adults Had Substantial Problems Paying Medical Bills

4%

11% 13%

30%

17%

36%

0%

10%

20%

30%

40%

Problems Paying Bills Had to Change Way of LifeSignificantly to Pay Bills



Nearly Half of Uninsured/Recent Gap AdultsHad Access or Bill Problems

11% 11%17%

38%33%

46%

0%

20%

40%

60%

Access Problem* Bill Problem Access or Bill Problem


Continuously Insured Currently Uninsured or Recent Gap

* Time you didn’t get needed care or didn’t fill needed prescription

ADULTS WITH HEALTH PROBLEMS

One-Third in Fair or Poor Health Were Uninsuredor Had a Recent Gap*

ContinuouslyInsured

64%

Recent Gap13%

CurrentlyUninsured

22%


29 million adults age 18-64with fair/poor health status

Two-Thirds of Uninsured Adults in Fair or Poor Health Went Without Needed Care in the Past Year

25%25%

56%

66% 66%66%

0%

20%

40%

60%

80%

Did Not Get Care or Prescription Postponed Care Due to Cost


29 million adults age 18-64 in fair or poor health

Three in Four Uninsured Adults with Health Problems Had Access or Bill Problems

34%

21%25%

76%

57%66%

0%

20%

40%

60%

80%

Access Problem* Bill Problem Access or Bill Problem

29 million adults age 18-64 in fair or poor health

Continuously Insured Currently Uninsured or Recent Gap

* Time you didn’t get needed care or didn’t fill needed prescription

ADULTS IN WORKING FAMILIES

As Wages Decrease, Access or Bill Problems Increase for Working Families

12%16%

24%

41%

24%

0%

20%

40%

60%

Total $20,000 orLess

$20,001-$35,000

$35,001-$60,000

Above $60,000

Percent not getting needed care or prescriptions and/or had medical bill problems in past year

128 million adults age 18-64 in families with a FT or PT worker

Note: In 1996, 200% of poverty was about $21,000 for a family of two and $25,000 for a family of three

One-Third of Low-Wage Working Families Had Problems Paying Medical Bills

7%11%

18%14%

18%

32%

3%7%

10%

0%

10%

20%

30%

40%

Bill Problems Collection Agency Family Changed Way ofLife


All Working Families Below 200% Poverty 200% Poverty or More

Uninsured Adults in Working Families Had Access and Cost Difficulties

15%11%9%

43%

30%31%

48%

37%41%

0%

20%

40%

60%

Did Not Get Care orPrescription

Bill Problem Access or Bill Problem



Low-Wage Working Families at High Risk of Access or Cost Problems

Access or Bill Problem in Past Year

25%

13%

54%

33%

0%

20%

40%

60%

Less than 200% Poverty 200% Poverty or More

Adults age 18-64 in families with a FT or PT worker

Continuously Insured Currently or Recently Uninsured

CHOICE OF PLANS FROM EMPLOYERS FOR WORKING-AGE ADULTS

Majority of Adults Do Not Have a Choiceof Plans from Their Employer

One PlanOffered

41%

No Plans18%

EmployerOffers Choice

41%

NO CHOICEOF PLANS

Low-Wage Workers Are the Least Likely to Have a Choice of Health Plans*

22%37%

54% 56%

40%

49%

37% 35%37%

9%9%14%

0%

25%

50%

75%

100%

$20,000 or less $20,001 to35,000

$35,001 to60,000

Above $60,000

Employed adults age 18-64

Employer Offers Choice One Plan No Plan

* Totals may not add to 100% due to rounding

Larger Employers Are More Likely to Offera Choice of Plans

27%

54%72%41%

63%

43%27%

44%

15%

1%2%10%

0%

25%

50%

75%

100%

Less than 26Employees

26-100 Employees 101-500Employees

More than 500Employees

Employed adults age 18-64 by employer size

Employer Offers Choice One Plan No Plans

Married Adults Are More Likely to HaveChoice if Two-Worker Family

No Plans19%

One Plan41%

Choice ofPlan from

Own Employer41%

Choice ofPlan from

Own Employer34%

Choice ofPlan from

Spouse Employer14%

One Planfrom EachEmployer

15%

One Plan24%

No Plans13%

Married adults Single adults

MEDICARE: EXPERIENCES OF ADULTS AGE 65 AND OLDER COMPARED WITH

WORKING-AGE ADULTS

Medicare Beneficiaries Were the Most Satisfied with Health Care Services

27%

46%45%

57%

45%

0%

20%

40%

60%

80%

Total Medicare Medicaid Employer Uninsured

Adults age 18 and older

Percent very satisfied with health care services

Medicare Beneficiaries Were the Most Satisfiedwith Insurance and Plan Choice of Doctors

45%44%

64%

49%55%

50%

74%

59%

0%

20%

40%

60%

80%

Total Medicare Medicaid Employer

Very Satisfied with Insurance Very Satisfied with Choice of Doctors

Adults age 18 and older

Elderly Were Less Likely to Have a Time They Didn’t Get Needed Care than Adults Under Age 65

33%

11%

20%

7%

42%

0%

15%

30%

45%

Age 65+ Total 18-64 ContinuouslyInsured

Recent Gap CurrentlyUninsured

Percent not getting needed care or prescription in past year

Adults Age 18-64

Elderly Were Less Likely to Have Problems Paying Medical Bills than Adults Under Age 65

30%

11%

18%

7%

36%

0%

15%

30%

45%



Percent with problem paying medical bills in the past year

Adults Age 18-64

Elderly Were Less Likely to Have Disruption in Physician Care than Adults Under Age 65

24%

41%36%

54%

23%

0%

20%

40%

60%



Percent with regular doctor five years or more

Adults Age 18-64

WORRIES ABOUT HEALTH CARE: ELDERLY AND NON-ELDERLY

COMPARED

Worries About Access and Health CostsPercent who worry “a great deal” or “a lot”

40%

51%

48%

55%

30%

40%

37%

45%30%

24%

23%

17%

0% 20% 40% 60%

Unaffordable HealthInsurance

Unaffordable MedicalBills

Won't Get NeededSpecialty Care

Won't Get NeededProcedure

Age 65+

Age 18-64 Total

Age 18-64 Low-Wage*

* Less than 200% of poverty

Insurance Gaps Contributed to Non-Elderly Worries About Bills and Access

30%23%

46%

36%

57%50%

0%

20%

40%

60%

Won't Get Needed Procedure Unaffordable Medical Bills


Percent who worry “a great deal” or “a lot”


Support for Health Insurance Coverage Reform

93%93%94% 93%87%86%

0%

25%

50%

75%

100%

Covering All Children Making Sure AllWorking Families Have

Insurance

Preserving Medicare

Age 18-64 Age 65+Percent favor

TRENDS: COMPARISONS OF KAISER/COMMONWEALTH 1993 AND 1997

NATIONAL SURVEYS

Uninsured Rates Remain High Despitean Improved Economy

68% 68%

14% 13%18% 19%

0%

20%

40%

60%

80%

1993 1997

Adults age 18-64


Note: 1993 data are from the Kaiser/Commonwealth 1993 Survey

Health Care Access Concerns Persist over Time for Working-Age Adults

14%

21%26%

33%

13%

22%

30%

23%

0%

10%

20%

30%

40%

Not Get NeededCare

No Visit No RegularDoctor

Posponed CareDue to Costs

Adults age 18-64

1993 1997

Note: 1993 data are from the Kaiser/Commonwealth 1993 Survey

Documents

HEALTH INSURANCE COVERAGE OF WORKING-AGE ADULTS. One-Third of Working-Age Adults Were Currently Uninsured or Had a Recent Gap* 164 million adults age