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%
* Recent gap = insured when surveyed but had a period in past 2 years without coverage
<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
164 million adults age 18-64
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
Continuously Insured Recent Gap Currently Uninsured
164 million adults age 18-64
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
Continuously Insured Recent Gap Currently Uninsured
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
164 million adults age 18-64
Continuously Insured Recent Gap Currently Uninsured
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
164 million adults age 18-64
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%
* Recent gap = insured when surveyed but had a period in past 2 years without coverage
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
Continuously Insured Recent Gap Currently Uninsured
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
128 million adults age 18-64 in familieswith a FT or PT worker
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
Continuously Insured Recent Gap Currently Uninsured
128 million adults age 18-64 in familieswith a FT or PT worker
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%
Age 65+ Total 18-64 ContinuouslyInsured
Recent Gap CurrentlyUninsured
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%
Age 65+ Total 18-64 ContinuouslyInsured
Recent Gap CurrentlyUninsured
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
Continuously Insured Recent Gap Currently Uninsured
Percent who worry “a great deal” or “a lot”
164 million adults age 18-64
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
Continuously Insured Recent Gap Currently Uninsured
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