census

HEALTH INSURANCE
COVERAGE IN THE
UNITED STATES
Highlights
• The number of people with health
insurance coverage increased from
245.9 million in 2004 to 247.3 million
in 2005. 31
• In 2005, 46.6 million people were
without health insurance coverage,
up from 45.3 million people in
2004 (Table 8).
• The percentage of people without
health insurance coverage
increased from 15.6 percent in
2004 to 15.9 percent in 2005.
• The historical record is marked by a
12-year period from 1987 to 1998
when the uninsured rate (12.9 percent
in 1987) either increased or
was not statistically different from
one year to the next (Figure 7). 32
After peaking at 16.3 percent in
1998, the rate fell for 2 years in a
row to 14.2 percent in 2000. The
rate then increased until
2003–2004, where it remained at
31
The 2004 data have been revised to reflect a
correction to the weights in the 2005 ASEC, and the
estimates were revised based on improvements to
the algorithm that assigns coverage to dependents.
For a brief description of how the Census Bureau
collects and reports on health insurance, see the
text box “What Is Health Insurance Coverage?” For a
discussion of the quality of ASEC health insurance
coverage estimates, see Appendix C.
32
The year 1987 is the first year for which
comparable health insurance coverage statistics
are available.
What Is Health Insurance Coverage?
The Annual Social and Economic Supplement (ASEC) to the Current
Population Survey (CPS) asks about health insurance coverage in the previous
calendar year. The questionnaire asks separate questions about the
major types of health insurance, and people who answer “no” to each of
the coverage questions are then asked to verify that they were, in fact,
not covered by any type of health insurance. For reporting purposes, the
Census Bureau broadly classifies health insurance coverage as private coverage
or government coverage. Private health insurance is a plan provided
through an employer or a union or purchased by an individual from a private
company. Government health insurance includes the federal programs
Medicare, Medicaid, and military health care; the State Children’s
Health Insurance Program (SCHIP); and individual state health plans.*
People were considered “insured” if they were covered by any type of
health insurance for part or all of the previous calendar year. They were
considered “uninsured” if they were not covered by any type of health
insurance at any time in that year.
Research shows health insurance coverage is underreported in the CPS
ASEC for a variety of reasons. While annual retrospective questions appear
to be less of a problem when collecting income data (possibly because the
interview period is close to when people pay their taxes), it is probably
less than ideal when asking about health insurance coverage. For example,
some people may report their insurance coverage status at the time
of their interview rather than their coverage status during the previous
calendar year. Compared with other national surveys, the CPS ASEC’s estimate
of the number of people without health insurance more closely
approximates the number of people who were uninsured at a specific
point in time during the year than the number of people uninsured for the
entire year.
For more information on the quality of CPS ASEC health insurance estimates,
see Appendix C, “Estimates of Health Insurance Coverage.” For a
comparison between health insurance coverage rates from the major federal
surveys, see How Many People Lack Health Insurance and for How
Long? (Congressional Budget Office, May 2003) and People with Health
Insurance: A Comparison of Estimates from Two Surveys (Survey of
Income and Program Participation Working Paper 243, June 2004).
* Types of insurance are not mutually exclusive and people may be covered by more than
one during the year.
20 Income, Poverty, and Health Insurance Coverage in the United States: 2005 U.S. Census Bureau