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How Many People Lack Health Insurance and for How Long 1 (May 2003)

handle is hein.congrec/cbo9255 and id is 1 raw text is: A series of issue summari.es from the Congressional Budget Office MAY 12, 2003 How Many People Lack Health Insurance and For How Long? It is frequently stated that about 40 million Americans lack health insurance. That estimate overstates the number of people who are uninsured all year. The Congressional Bud- get Office (CBO) estimates that between 21 million and 31 million people were uninsured for all of 1998, the most recent year for which reliable comparative data are avail- able. Since then, the number who are uninsured all year probably has not changed substantially, given historical trends. Furthermore, the uninsured population is fluid, with many people gaining and losing coverage. Between half and two-thirds of the people who experienced a period of time without insurance in 1998, for example, had cover- age for other portions of the year. Alternative Approaches to Measuring the Uninsured The commonly cited estimate of 40 million uninsured comes from the Census Bureau's Current Population Sur- vey (CPS). Based on a large nationally representative sample, the CPS has been collecting data on insurance status since 1980. Although the CPS is designed to measure the number of people who lack health coverage for a whole year, its estimate more closely approximates the number ofpeople who are uninsured at a specific point in time dur- ing the year. Data from three large federally sponsored national surveys-the Survey of Income and Program Par- ticipation (SIPP), the Medical Expenditure Panel Survey (MEPS), and the National Health Interview Survey (NHIS)-yield estimates of the number of uninsured at a given point in time that are very similar to the CPS esti- mate of about 40 million (see Figure 1).' Data from SIPP and MEPS indicate that 21 million to 31 million people lacked health insurance for all of 1998. Unlike the CPS, which interviews people in March about 1. SIPP is sponsored by the Census Bureau, MEPS by the Agency for Healthcare Research and Quality, and NHIS by the Centers for Disease Control and Prevention. their insurance status during the previous calendar year, SIPP and MEPS interview people multiple times in a year. By asking people to recall their insurance coverage over a shorter period of time than the CPS requires, SIPP and MEPS should yield more accurate estimates of the number of people who are uninsured all year. A third measure of the uninsured is the number of people who lack insurance at any time during the year. According to data from SIPP and MEPS, nearly 60 million Americans Figure 1. Estimated Number of Nonelderly People Without Health Insurance in 1998 (In millions) 80 1 70 60 50 40 30 20 10 0 F-1 Survey of Income and Program Participation - * Medical Expenditure Panel Survey F71 National Health Interview Survey 59.0 - a r, a 42.6 39.0 Uninsured Uninsured for the at a Specific Entire Year Point in Time During the Year Uninsured at Any Time During the Year Source: Congressional Budget Office. Note: The Centers for Disease Control and Prevention, which sponsors the NHIS, reports only the point-in-time estimate.

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