NCPA - National Center for Policy Analysis

More Uninsured, But Not for Long

May 13, 2003

The Census Bureau estimates that 41 million Americans have no health insurance. But the Congressional Budget Office said the bureau's figure "overstates the number of people who are uninsured all year," while understating the number who are insured for only part of the year.

Although more than 240 million Americans have private health insurance or are covered by government health programs, CBO researchers estimate that:

  • Some 57 million to 59 million people, "about a quarter of the nonelderly population," lacked insurance at some time in 1998, the most recent year for which reliable comparative figures are available.
  • At the same time, government surveys suggest that the number of people uninsured for the entire year was 21 million to 31 million, or 9 percent to 13 percent of nonelderly Americans.

The widely used figure from the Census Bureau is based on interviews conducted by the government as part of the Current Population Survey in March of each year.

  • The Census questions about insurance are meant to identify people who were uninsured for all the prior calendar year.
  • But the CBO says that many people "report their insurance status as of the time of the interview, rather than for the previous calendar year as requested."

Congressional Budget Office Director Douglas J. Holtz-Eakin says that "the uninsured population is constantly changing. While many people are chronically uninsured, many more are uninsured for shorter periods of time."

How long do people go without coverage when they are uninsured? The CBO estimates that of those who became uninsured from mid-1996 to mid-1997, 45 percent were uninsured for four months or less, 26 percent were uninsured for 5 to 12 months and 13 percent lacked coverage for 13 to 24 months. Just 16 percent were uninsured more than two years.

Source: Robert Pear, "New Study Finds 60 Million Uninsured During a Year," New York Times, May 13, 2003; "How Many People Lack Health Insurance and for How Long?" May 2003, Congressional Budget Office, Washington, D.C.


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