Covering the Uninsured: Prospects and Problems

Increasing the number of Americans with health insurance has been a recurrent focus of federal and state policymaking, and recent trends suggest that the issue continues to warrant legislative attention. The number of people without health insurance coverage in the United States increased in 2001, a reversal of two years of falling rates of uninsurance. According to the Census Bureau, an estimated 14.5 percent of the total population (41.2 million people) lacked health insurance for the entire year in 2001, up from 14.2 percent in 2000—an increase of 1.4 million people. Insurance coverage varies by state of residence, with New Mexico and Texas having the highest average uninsured rates from 1999 to 2001 (23 percent) and Rhode Island and Minnesota the lowest (7.8 percent). Private employment-based insurance remains the primary source of insurance coverage for most Americans, but public programs such as Medicare, Medicaid, and the state Children's Health Insurance Program (CHIP) are an important source of coverage for millions of elderly and disabled individuals and low-income children and adults.