Today, the Census Bureau released the latest data on the number of Americans without health insurance: in 2006, the number of uninsured rose to 47 million, from 44.8 million in 2005. This increase of 2.2 million—a jump of 5 percent—is the largest one-year increase in the number of uninsured since 2002. The ranks of the uninsured have grown 8.6 million since 2000—an increase of 22 percent.
The number of uninsured children rose to 8.7 million in 2006, up from 8.0 million in 2005—an increase of 9 percent in one year alone. If not for coverage through Medicaid and the State Children's Health Insurance Program (SCHIP), even more children would be without coverage. Since 2000, Medicaid and SCHIP provided an additional 5 million children with health coverage.
Nearly all uninsured adults are employed, and are increasingly likely to be in middle-class families. In 2006, an additional 1.3 million working adults were uninsured, of which 1.2 million worked full time. Both younger adults ages 25 to 34 and older adults ages 45 to 64 experienced major increases in the number of uninsured, a sign of the difficulty of obtaining health coverage in entry-level jobs and of staying covered as older adults experience serious health problems. Those particularly affected by the loss of coverage have incomes between $25,000 and $75,000. But even among those in families earning more than $75,000, the number of uninsured grew by 1.4 million.
Today's news is very disturbing. It means more Americans are going without needed care or facing crushing financial bills. Lack of insurance undermines the quality of care, as the uninsured fail to receive preventive care and cannot afford to take the medications that would keep their chronic conditions under control. And it undermines the health and productivity of our workforce and the strength of our economy.
One immediate action Congress could take is reauthorization of SCHIP, which is essential to prevent a reversal of the progress made through public health insurance programs over the last six years. While politicians may disagree about whether government or private markets are the solution to covering children and improving the quality of health care in the United States, health care leaders do not. In a recent Commonwealth Fund/Modern Healthcare survey, health care leaders said loud and clear that children up to 300 percent of the poverty level need to be covered by SCHIP and that the federal government can play a strong role in reforming health care overall.
The SCHIP reform bills currently in Congress are an unprecedented opportunity to expand coverage and improve the quality of care for all of us, but they are only a beginning. These proposals are no substitute for the comprehensive national strategy and leadership needed to ensure that all Americans have access to high-quality, safe, and efficient health care. In order to achieve that goal, Congress and the President should:
- reauthorize SCHIP, covering most of the 8.7 million uninsured children—nearly all of whom are in families that cannot afford family health insurance premiums;
- provide financial assistance to states willing to test innovative approaches, rather than cutting back on state funding;
- begin serious examination of strategies for extending coverage to all Americans, building on platforms that work such as the Medicare program, employer coverage, and state initiatives;
- create a national agenda to end the stark variation in health status and health care quality among states;
- address payment reform to ensure that we are paying for quality, rather than quantity;
- support medical homes, or primary care providers that ensure children and adults receive accessible, coordinated care, and that have been shown to reduce health disparities; and
- support electronic medical records and the health information technology and infrastructure necessary to improve quality and efficiency.