Health Insurance Coverage In The United States

Health insurance coverage in the United States is a voluntary system. Employers offer coverage through the private insurance market to attract and retain workers and to maintain a healthy and productive workforce. Government-sponsored health insurance programs, including Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP), provide health insurance to vulnerable populations who often do not have access to employer-based insurance, such as low-income families, seniors and individuals with disabilities, children, and pregnant women. In addition, a small percentage of the population purchases health insurance through the non-group market, where an individual buys a policy directly from an insurance carrier.

Data from the Current Population Survey (CPS) show that just less than 59.5 percent of the U.S. population was covered through employment-based insurance plans in 2005, a slight decrease from 59.8 percent 2004. Government programs provided coverage to 27.3 percent of the insured population in 2005, including virtually everyone over 65 years of age receiving coverage through Medicaire¹.

Health insurance helps pay for the health care services that many Americans receive. Yet 46.6 million people were without health insurance in 2005². To access care, the uninsured must either pay out-of-pocket for services or navigate a patchwork of “free” and donated care through charity care facilities and community health centers. Uninsured individuals often delay or forgo needed health care because of its cost and, consequently, face worse health care outcomes as a result. The consequences are broader than those experienced by the individual and his or her family:

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¹ U.S. Census Bureau, Income, Poverty, and Health Insurance Coverage in the United States: 2005, August 2006.

² AcademyHealth, State of the State 2007: Building Hope, Raising Expectations, January 2007.