NCPA - National Center for Policy Analysis


March 30, 2007

Before elected officials can look for a solution to America's uninsured, they need to understand who is uninsured and why so many people lack coverage, says J.P. Wieske, director of state affairs for the Council for Affordable Health Insurance (CAHI).

There are many different groups who lack insurance, says Wieske.  For example:

  • The temporarily uninsured -- most people are uninsured for relatively short periods of time; the federal government estimates that about 45 percent are uninsured for six months or less.
  • Workers facing tax discrimination -- federal policy discriminates against people who buy their own coverage in the health insurance market; employers get a tax deduction and employees receive a tax exclusion.
  • Low income individuals -- for those with incomes less than $25,000, 24.4 are uninsured, versus only 8.5 percent of those with incomes above $75,000 are.
  • The young and healthy -- 30.6 percent of uninsured are between 18 and 24, and another 26.4 percent between 25 and 34; compared to virtually everyone older than 65.
  • The chronically ill -- they are often denied coverage or must pay higher premiums for coverage.

To help combat this, states have a number of targeted reforms at their disposal:

  • Creating high risk pools that provide coverage to those who are medically uninsurable.
  • Providing individual tax credits for employees without access to employer-provided coverage; and leveling the pretax playing field for those who purchase insurance on their own.
  • Increase list billing, whereby employers who do not provide coverage help employees purchase individual health insurance, and have the premiums deducted from their wages.
  • Allow out-of-state insurance purchases to those who are priced out of their own markets through community rating and guaranteed issue.

Source: J.P. Wieske, "Understanding the Uninsured," Council for Affordable Health Insurance (CAHI), 2007.

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