NCPA - National Center for Policy Analysis


August 27, 2004

The actual number of uninsured Americans may be a third less than 45 million reported by the Census Bureau, while another third of the uninsured appear to be wealthy enough to afford coverage, says the Wall Street Journal.

Who does the Census count as uninsured?

  • Devon Herrick of the National Center for Policy Analysis estimates that as many as 14 million uninsured children and adults who are eligible for Medicaid and the State Children's Health Insurance Program (or S-CHIP) are not enrolled.
  • Thus, it doesn't make much sense to count these individuals as uninsured, says the Journal, since they can enroll and have their expenses covered if and when they require health care, says the Journal.

And what about the "wealthy" uninsured?

  • The Census data for 2003 show almost 15 million uninsured people in households with incomes above $50,000 (7.6 million of them in households over $75,000).
  • That's hardly rich, but it is enough to afford coverage in most states if individuals treat health care with the priority it deserves.

Why do some choose not to insure?

  • There are 18.8 million of the uninsured are between the ages of 18 and 34, and many of them voluntarily (if unwisely) forgo coverage.
  • Their gamble is actually encouraged by "guaranteed issue" laws in many states that reassure the irresponsible that they can avoid buying insurance until they get sick.

Finally, the Congressional Budget Office estimated earlier this year that the number of those actually uninsured for the entire year is between 21.1 and 31.1 million. Perhaps the best proxy for who's really in need are the 14.8 million uninsured who the Census lists in households between $25,000 and $49,000 in annual income, says the Journal.

Source: Editorial, "Health and Poverty," Wall Street Journal, August 27, 2004.

For WSJ text (subscription required),,SB109356338582602540,00.html


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