Research
Findings #11: Health Insurance Status of the Civilian
Noninstitutionalized Population, 1998
Jeffrey A. Rhoades, Ph.D., Erwin Brown, Jr.,
B.S., and Jessica P. Vistnes, Ph.D., Agency for Healthcare Research
and Quality
Abstract
This report from the 1998 Medical Expenditure Panel Survey (MEPS) provides preliminary estimates of the health insurance status of the civilian noninstitutionalized U.S. population during the first half of 1998, including the size and characteristics of the population with private health insurance, with public insurance, and without any health care coverage. During this period, 84.2 percent of all Americans were covered by private or public health insurance, leaving 15.8 percent of the population, some 42.3 million people, uninsured. Among the non-elderly population, 82.2 percent of Americans had either private or public coverage and 17.8 percent of the population (42 million people) lacked health care coverage. Among the elderly population, there was a significant drop in private health insurance coverage and a significant increase in coverage by only public health insurance when compared to 1997 estimates. The probability that an individual would be uninsured during this period was especially high for young adults aged 19-24 and members of racial and ethnic minorities (especially Hispanic males). Public health insurance continues to play an important role in ensuring that children, black Americans, and Hispanic Americans obtain health care coverage.
Introduction
This report is the third in a series of
yearly reports on the health insurance status of the U.S.
population. The first report (Vistnes and Monheit, 1997) presented
health insurance estimates for the first half of 1996, and
the second (Vistnes and Zuvekas, 1999) presented health insurance
estimates for the first half of 1997. The yearly reports all
have the same format but give the most recent statistics and
point out noteworthy changes from the previous year.
The health insurance status of the U.S.
population, especially the size and composition of the uninsured
population, has become an issue of perennial public policy
concern for several reasons. First, health insurance is viewed
as essential to ensure that individuals obtain timely access
to medical care and protection against the risk of expensive
and unanticipated medical events. Compared to people without
health care coverage, insured individuals are more likely
to have a usual source of medical care, to spend less out
of pocket on health services, and to experience different
treatment patterns, quality, and continuity in their health
care (Lefkowitz and Monheit, 1991; U.S. Congress, Office of
Technology Assessment, 1992).
Second, concern over the population's health
insurance status reflects a variety of equity and efficiency
considerations. These include the magnitude and appropriate
mix of private and public sector responsibility for financing
health care, the impact of health insurance on the efficient
use of health care, and the manner in which health insurance
affects the distribution of health care among the general
population and across groups of specific policy interest.
Third, timely and reliable estimates of
the population's health insurance status are essential to
evaluate the costs and expected impact of public policy interventions
to expand coverage or to alter the manner in which private
and public insurance is financed. Identification of how individual
and household demographic characteristics, health status,
and economic circumstances are associated with the population's
health insurance status is of critical importance in developing
efficient and targeted policy interventions. This is especially
relevant given the current emphasis on incremental health
care reform that is focused on particular health care markets
and population groups.
Finally, comparisons of the characteristics
of insured and uninsured populations over time provide information
on whether greater equity has been achieved in the ability
of specific population groups to obtain health insurance or
whether serious gaps remain. In this regard, estimates of
the population's health insurance status from the Medical
Expenditure Panel Survey (MEPS), which is conducted annually,
provide critical data for evaluating the health insurance
implications of recent legislative initiatives: the 1996 Health
Insurance Portability and Accountability Act (HIPAA), Public
Law 104-191; welfare reform under the 1996 Personal Responsibility
and Work Opportunity Reconciliation Act, Public Law 104-193;
and the 1997 State Children's Health Insurance Program (SCHIP).
A primary goal of HIPAA is to reduce the impact of preexisting
health conditions on the continuity of health insurance during
employment transitions. Under welfare reform, mandated work
requirements and time limitations governing the receipt of
public assistance may have consequences for a recipient's
health insurance status. The goal of the SCHIP program is
to provide health insurance coverage to low-income children
who are not eligible for Medicaid.
This report presents preliminary estimates
of the number and characteristics of people with private and
public health insurance at any time during the first half
of 1998, on average. Particular emphasis is directed toward
estimating the size of the population that was uninsured throughout
the first half of 1998 and identifying groups especially at
risk of lacking health insurance.
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Overview
During the first half of 1998, on average,
84.2 percent of all Americans in the civilian noninstitutionalized
population had some type of private or public health insurance
coverage (Table 1). Nearly 69
percent of Americans obtained health insurance from private
sources. Another 15.6 percent obtained public sources of coverage,
primarily from the Medicare and Medicaid programs. The remaining
15.8 percent of Americans, 42.3 million people, were without
health insurance throughout the first half of 1998. Among
the non-elderly population, 70.4 percent were covered by private
insurance and 11.8 percent by public insurance. Among the
non-elderly population, an estimated 42.0 million people (17.8
percent) were uninsured. Table 2 gives
more detailed information on the health insurance status of
the non-elderly population.
Overall these health insurance estimates
do not differ significantly from the 1997 MEPS figures for
the non-elderly population reported in Vistnes and Zuvekas,
1999. However, there were differences between the two years
for the elderly population. These differences are discussed
below.
Tables 1-3 provide
estimates of the population's health insurance status according
to selected demographic characteristics, perceived health
status, employment status, and residential location. Table
4 provides estimates of the distribution of the uninsured
population by selected characteristics. Table
A in the Technical Appendix provides estimates of the
number of people by health insurance status. Some of the key
findings and relationships revealed by these data are discussed
below.
Age
MEPS data reveal that, in general, children
are more likely than non-elderly adults to have health insurance
coverage. The main findings among age groups are described
next.
Children
There has been considerable interest in
the health insurance status of children. This interest stems
from the role health care coverage plays in ensuring that
children obtain the medical care appropriate to their specific
stage of development. To help ensure such coverage, Congress
passed the State Children's Health Insurance Program in 1997,
allocating approximately $24 billion over 5 years to provide
health insurance coverage to low-income children who are not
eligible for Medicaid. The SCHIP program follows on Medicaid
expansions beginning in the late 1980s that focused attention
on the role of the public and private sectors in financing
health care for low-income children.
MEPS data indicate that public health
insurance covered a substantial proportion of children in
the first half of 1998: Nearly 30 percent of children under
age 4, one in four children ages 4-6, and close to one in
five children ages 7-12 had public coverage, primarily through
Medicaid. As a result, children under age 18 were less likely
to be uninsured than were non-elderly adults in general. Despite
this finding, about 10.6 million children lacked health care
coverage.
Adults
Young adults ages 19-24 were the age group
most likely to lack health insurance. Nearly a third of young
adults (31.8 percent) were uninsured, twice the rate at which
all Americans lacked coverage. Young adults ages 19-24 also
had the lowest rate of private health insurance coverage among
the non-elderly adult population.
On the other hand, over half of elderly
Americans (55.3 percent) were covered by private health insurance.
More than 4 out of 10 elderly Americans (43.8 percent) held
only public coverage (Medicare alone or in conjunction with
Medicaid). These estimates differ significantly from estimates
for 1997, when 60.5 percent of the elderly were covered by
private health insurance and 38.4 percent were covered by
public health insurance only. Presently there are insufficient
data to determine why these changes have occurred between
the two years.
Employment Status
Since most private health insurance in the
United States is provided through the workplace, employment
status is an important indicator of access to private health
insurance. MEPS data reveal the following for the population
ages 16-64 (Table 2):
- Over three-quarters (79.9 percent) of
workers were covered by private health insurance, compared
to half (51.2 percent) of individuals who were not employed.
- People who were not employed were more
likely than workers to be covered by public insurance (23.1
and 3.4 percent, respectively).
- Workers were less likely than people
who were not employed to be uninsured (16.6 and 25.6 percent,
respectively).
Race/Ethnicity
MEPS data indicate that significant disparities
exist in the rate at which racial and ethnic minorities are
covered by private and public health insurance compared to
white Americans (Table 1). For
example:
- Less than half of all Hispanic Americans
(46.9 percent) and half of black Americans (50.2 percent)
were covered by private health insurance, compared to three-quarters
of whites (75.7 percent). Close to a third of Hispanics
(31.8 percent) and a fifth of blacks (20.6 percent) were
uninsured. In contrast, 12.2 percent of white Americans
were uninsured.
- Among all racial/ethnic groups, Hispanic
males were the most likely to be uninsured; 33.9 percent
lacked coverage.
- Hispanic and black Americans were more
likely than white Americans to be covered by public health
insurance (21.3 percent and 29.2 percent, respectively,
compared to 12.1 percent).
Marital Status
Married individuals were more likely than
others to have private health insurance (Table
1). As shown in Table 2,
among people ages 16-64, married individuals were more likely
than others to have private health insurance (81.8 percent)
and less likely to have public insurance (4.5 percent) or
be uninsured (13.7 percent). Of people ages 16-64 who were
not married at the time of the survey:
- Almost one-quarter of widowed persons
were uninsured (23.1 percent).
- Over a fifth of all divorced persons
(21.7 percent) were uninsured.
- Over one-quarter of Americans who were
separated were uninsured (28.8 percent).
- More than one-quarter of Americans who
never married were uninsured (26.3 percent).
Residential Location
The type of health care coverage obtained
by Americans and the likelihood of being uninsured also varied
by region and whether they lived in a metropolitan statistical
area (MSA). MEPS data show that:
- People living in the South and West were
less likely than residents of other regions to have private
health insurance (64.8 percent and 65.0 percent in the South
and West, respectively, compared to 70.8 percent and 76.1
percent of residents in the Northeast and Midwest). Nearly
one out of five persons in the South and West were uninsured
(18.8 percent and 18.1 percent, respectively), compared
to 12.7 and 11.4 percent in the Northeast and Midwest, respectively.
- People living outside MSAs were less
likely than those living within MSAs to be covered by private
health insurance (64.0 percent vs. 69.8 percent).
Health Status
There is considerable public policy interest
in determining whether people with health problems are able
to obtain health insurance and, if so, the source of such
coverage. MEPS respondents were asked to rate their health
and family members' health as excellent, very good, good,
fair, or poor. The data in Table
3 reveal the relationships described below between health
status and insurance coverage.
Non-Elderly People
More than one in five non-elderly Americans
in good health (20.8 percent), fair health (23.2 percent),
or poor health (22.8 percent) were uninsured throughout the
first half of 1998. Among the non-elderly:
- People in fair or poor health were less
likely than those in better health to have private health
insurance. Only 41.2 percent of those in poor health and
53.8 percent of those in fair health had any private coverage.
- Public insurance helped to reduce the
health-related disparities in private coverage. Over 20
percent of people in fair health and over one-third of people
in poor health had public coverage. Nevertheless, those
in only good or fair health were more likely than people
in very good or excellent health to be uninsured.
Elderly People
Elderly Americans in poor health were less
likely to have private coverage than those in good or better
health. As a result, those in poor health were more likely
to be covered by insurance from public sources only (55.9
percent) than other elderly Americans. Medicare, either alone
or with Medicaid, was the main public source of coverage.
There were significant differences between the 1997 and 1998
estimates for elderly people in good health. The percent covered
by private health insurance decreased significantly, from
63.3 in 1997 to 55.5 percent in 1998. There was a corresponding
significant increase in the percent covered by public health
insurance only, from 35.9 in 1997 to 43.3 percent in 1998.
Presently there are insufficient data to determine why these
changes have occurred between the two years.
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Characteristics
of Uninsured Americans
Previous sections of this report have described
the health insurance status of Americans by focusing on demographic,
health status, and geographic characteristics associated with
the likelihood that particular groups obtained private or
public health insurance or were more at risk of being uninsured.
To put this discussion in perspective, data displayed in Table
4 characterize the uninsured population in terms of the
representation of specific groups in the general population
of non-elderly Americans relative to their representation
among the uninsured population. In this way, one can assess
whether certain population groups are disproportionately represented
among the uninsured. Such information can be useful in formulating
targeted policy interventions on behalf of people without
health insurance.
Age
Children under age 18 comprised just over
one-quarter (25.2 percent) of the uninsured population. Young
adults ages 19-24 composed 8.8 percent of the non-elderly
population but 15.7 percent of the uninsured population. Young
adults had the greatest risk of being uninsured of any age
group.
Sex
While males made up slightly less than half
of the non-elderly population, they represented 54.0 percent
of the uninsured population.
Race/Ethnicity
Racial and ethnic minorities were more at
risk of lacking health insurance than white Americans were.
As a result, minority representation among the uninsured exceeded
their representation among the general population. For example:
- Although Hispanics represented only 12.3
percent of the non-elderly U.S. population, they accounted
for 23.1 percent of the uninsured population.
- Hispanic males were the racial/ethnic
group most likely to be uninsured. They represented only
6.4 percent of all non-elderly Americans but 12.6 percent
of the uninsured population.
- Although 7 out of 10 non-elderly Americans
were white, whites accounted for less than 6 out of 10 uninsured
persons.
- When the uninsured are categorized by
race/ethnicity and sex, white males represent the largest
proportion of the uninsured population.
Other Factors
People with specific residential locations
and marital status were also disproportionately represented
among the uninsured:
- People living in the South represented
about a third (35.0 percent) of all non-elderly Americans
but 42.0 percent of all uninsured Americans. Nearly 70 percent
of the uninsured population, but less than 60 percent of
non-elderly Americans, resided in the South or West.
- People who never married accounted for
over a fifth of the non-elderly population but over a third
of the uninsured population.
Finally, more than 1 out of 10 uninsured
people (11.5 percent of the uninsured population) were in
fair or poor health. These individuals are of particular policy
concern because of the importance of health insurance in assuring
timely access to needed health care services.
^top
Conclusions
Preliminary estimates from the 1998 MEPS
reveal that, during the first half of 1998, 68.6 percent of
Americans obtained health insurance from private sources,
15.6 percent obtained coverage through public programs, and
15.8 percent of the population (42.3 million people) lacked
any health care coverage. Among the non-elderly population,
over one person in six was uninsured.
In general, there was no difference between
the 1997 and 1998 estimates. However, among the elderly population
there was a significant drop in the rate of private health
insurance coverage and a significant increase in public health
insurance coverage only.
The tabulations presented in this report
indicate that the health insurance status of the U.S. population
is strongly associated with specific demographic characteristics,
health status, and employment status. Important disparities
in health care coverage exist for particular groups. Among
the groups especially at risk of lacking health care coverage
are young adults ages 19-24 and members of racial and ethnic
minorities (especially Hispanic males). Public health insurance
continues to play an important role in insuring children,
black Americans, and Hispanic Americans. Disparities in rates
of insurance coverage also exist by health status, with non-elderly
people in good or fair health more likely than people in better
health to be uninsured.
^top
Tables
Table
1. Health insurance coverage of the civilian noninstitutionalized
population: Percent by type of coverage and selected population
characteristics, United States, first half of 1998
Population
characteristic |
Total
population
in thousands |
Private |
Public
only |
Uninsured |
| Percent
distribution |
| Totala |
268,297 |
68.6 |
15.6 |
15.8 |
| Total under
age 65a |
236,214 |
70.4 |
11.8 |
17.8 |
| Age
in years |
| Under 4 |
15,817 |
59.4 |
27.6 |
13.1 |
| 4-6 |
11,843 |
61.6 |
24.3 |
14.1 |
| 7-12 |
24,467 |
66.6 |
18.7 |
14.7 |
| 13-17 |
20,032 |
69.7 |
14.1 |
16.2 |
| Total under
18 |
72,160 |
65.1 |
20.3 |
14.7 |
| 18 |
3,729 |
67.6 |
12.3 |
20.1 |
| 19-24 |
20,779 |
59.1 |
9.1 |
31.8 |
| 25-29 |
18,881 |
64.5 |
8.1 |
27.4 |
| 30-34 |
20,123 |
71.1 |
8.1 |
20.8 |
| 35-54 |
78,598 |
78.2 |
6.8 |
15.1 |
| 55-64 |
21,944 |
76.2 |
10.9 |
12.9 |
| 18-64 |
164,055 |
72.8 |
8.1 |
19.1 |
| 65 and over |
32,082 |
55.3 |
43.8 |
0.9 |
| Employment
statusb |
| Employed |
133,653 |
79.4 |
4.5 |
16.1 |
| Not employed |
70,133 |
52.4 |
31.7 |
15.9 |
| Sex |
| Male |
130,999 |
68.9 |
13.7 |
17.4 |
| Female |
137,298 |
68.4 |
17.4 |
14.2 |
| Total Hispanic |
30,726 |
46.9 |
21.3 |
31.8 |
| Total black |
33,643 |
50.2 |
29.2 |
20.6 |
| Total white |
193,489 |
75.7 |
12.1 |
12.2 |
| Total other |
10,439 |
61.0 |
19.8 |
19.2 |
| Hispanic male |
15,700 |
47.1 |
19.0 |
33.9 |
| Black male |
15,679 |
50.0 |
26.8 |
23.2 |
| White male |
94,638 |
76.1 |
10.4 |
13.6 |
| Other male |
4,983 |
61.0 |
19.3 |
19.7 |
| Hispanic female |
15,026 |
46.7 |
23.7 |
29.6 |
| Black female |
17,964 |
50.4 |
31.3 |
18.3 |
| White female |
98,851 |
75.4 |
13.8 |
10.9 |
| Other female |
5,456 |
60.9 |
20.3 |
18.8 |
| Marital
statusb |
| Married |
110,197 |
78.8 |
9.6 |
11.6 |
| Widowed |
13,544 |
50.7 |
43.1 |
6.2 |
| Divorced |
20,859 |
62.2 |
18.2 |
19.6 |
| Separated |
4,900 |
50.6 |
22.1 |
27.2 |
| Never married |
54,933 |
61.6 |
12.8 |
25.7 |
| Metropolitan
statistical area (MSA) |
| MSA |
215,524 |
69.8 |
15.0 |
15.3 |
| Non-MSA |
52,772 |
64.0 |
18.2 |
17.8 |
| Census
region |
| Northeast |
51,205 |
70.8 |
16.5 |
12.7 |
| Midwest |
62,723 |
76.1 |
12.4 |
11.4 |
| South |
94,014 |
64.8 |
16.4 |
18.8 |
| West |
60,355 |
65.0 |
17.0 |
18.1 |
- a Includes persons with unknown
employment status and marital status.
- b For individuals age 16 and
over.
Note: Percents may not add to 100
because of rounding.
Source: Center for Financing, Access,
and Cost Trends, Agency for Healthcare Research and Quality:
Medical Expenditure Panel Survey Household Component, 1998.
^top
Table 2. Health insurance
coverage of the civilian noninstitutionalized population
under age 65: Percent by type of coverage and selected
population characteristics, United States, first half
of 1998
Population
characteristic |
Total
population
in thousands |
Private |
Public
only |
Uninsured |
| Percent distribution |
| Totala |
236,214 |
70.4 |
11.8 |
17.8 |
| Employment
statusb |
| Employed |
129,333 |
79.9 |
3.4 |
16.6 |
| Not employed |
42,453 |
51.2 |
23.1 |
25.6 |
| Sex |
|
|
|
|
| Male |
117,475 |
70.0 |
10.8 |
19.3 |
| Female |
118,740 |
70.9 |
12.8 |
16.3 |
| Race/ethnicity |
| Total Hispanic |
29,108 |
48.2 |
18.5 |
33.3 |
| Total black |
30,999 |
51.8 |
26.1 |
22.1 |
| Total white |
166,299 |
78.2 |
7.7 |
14.1 |
| Total other |
9,808 |
63.5 |
16.4 |
20.1 |
| Hispanic male |
15,019 |
47.9 |
16.8 |
35.3 |
| Black male |
14,623 |
50.7 |
24.8 |
24.6 |
| White male |
83,064 |
77.8 |
6.8 |
15.4 |
| Other male |
4,768 |
62.3 |
17.4 |
20.2 |
| Hispanic female |
14,089 |
48.6 |
20.2 |
31.2 |
| Black female |
16,375 |
52.9 |
27.2 |
19.9 |
| White female |
83,235 |
78.6 |
8.5 |
12.8 |
| Other female |
5,040 |
64.7 |
15.4 |
19.9 |
| Marital
statusb |
| Married |
92,575 |
81.8 |
4.5 |
13.7 |
| Widowed |
3,071 |
60.1 |
16.8 |
23.1 |
| Divorced |
18,655 |
64.5 |
13.8 |
21.7 |
| Separated |
4,638 |
51.8 |
19.4 |
28.8 |
| Never married |
53,414 |
62.2 |
11.4 |
26.3 |
| Metropolitan
statistical area (MSA) |
| MSA |
191,011 |
71.6 |
11.3 |
17.1 |
| Non-MSA |
45,203 |
65.5 |
13.8 |
20.7 |
| Census region |
| Northeast |
44,517 |
73.3 |
12.4 |
14.3 |
| Midwest |
55,004 |
77.6 |
9.4 |
13.0 |
| South |
82,594 |
66.8 |
11.9 |
21.4 |
| West |
54,100 |
66.5 |
13.5 |
20.0 |
- a Includes
persons with unknown employment status and marital status.
- b For
individuals age 16 and over.
Note: Percents may not add to 100
because of rounding.
Source: Center for Financing, Access,
and Cost Trends, Agency for Healthcare Research and Quality:
Medical Expenditure Panel Survey Household Component, 1998.
^top
Table 3. Health insurance
coverage of the civilian noninstitutionalized population:
Percent by type of coverage and perceived health status,
United States, first half of 1998
Population
characteristic |
Total
population
in thousands |
Private |
Public
only |
Uninsured |
| Percent
distribution |
| Total under age 65a |
236,214 |
70.4 |
11.8 |
17.8 |
| Total age 65 and overa |
32,082 |
55.3 |
43.8 |
0.9 |
| Perceived health status,
under age 65 |
| Excellent |
88,319 |
74.8 |
9.3 |
15.9 |
| Very good |
74,463 |
74.5 |
9.1 |
16.3 |
| Good |
52,443 |
65.3 |
13.8 |
20.8 |
| Fair |
15,459 |
53.8 |
23.1 |
23.2 |
| Poor |
5,283 |
41.2 |
36.0 |
22.8 |
| Perceived
health status, age 65 and over |
| Excellent |
5,724 |
59.1 |
40.1 |
*0.8 |
| Very good |
8,213 |
61.4 |
37.6 |
*1.0 |
| Good |
9,597 |
55.5 |
43.3 |
*1.2 |
| Fair |
5,419 |
49.0 |
50.7 |
*0.3 |
| Poor |
2,567 |
42.7 |
55.9 |
*1.4 |
- a Includes
persons with unknown perceived health status.
- * Relative standard
error is greater than or equal to 30 percent.
Note: Percents may not add to 100
because of rounding.
Source: Center for Financing, Access,
and Cost Trends, Agency for Healthcare Research and Quality:
Medical Expenditure Panel Survey Household Component, 1998.
^top
Table 4. Total population
and uninsured persons under age 65: Percent by selected
population characteristics, United States, first half
of 1998
Population
characteristic |
Total
population
in thousands |
Percent
distribution
of population |
Percent
uninsured |
Percent
distribution of uninsured population |
| Percent
distribution |
| Totala |
236,214 |
100.0 |
17.8 |
100.0 |
| Age in years |
| Under 4 |
15,817 |
6.7 |
13.1 |
4.9 |
| 4-6 |
11,843 |
5.0 |
14.1 |
4.0 |
| 7-12 |
24,467 |
10.4 |
14.7 |
8.6 |
| 13-17 |
20,032 |
8.5 |
16.2 |
7.7 |
| Total under 18 |
72,160 |
30.5 |
14.7 |
25.2 |
| 18 |
3,729 |
1.6 |
20.1 |
1.8 |
| 19-24 |
20,779 |
8.8 |
31.8 |
15.7 |
| 25-29 |
18,881 |
8.0 |
27.4 |
12.3 |
| 30-34 |
20,123 |
8.5 |
20.8 |
10.0 |
| 35-54 |
78,598 |
33.3 |
15.1 |
28.2 |
| 55-64 |
21,944 |
9.3 |
12.9 |
6.8 |
| Sex |
| Male |
117,475 |
49.7 |
19.3 |
54.0 |
| Female |
118,740 |
50.3 |
16.3 |
46.0 |
| Race/ethnicity |
| Total Hispanic |
29,108 |
12.3 |
33.3 |
23.1 |
| Total black |
30,999 |
13.1 |
22.1 |
16.3 |
| Total white |
166,299 |
70.4 |
14.1 |
55.9 |
| Total other |
9,808 |
4.2 |
20.5 |
4.7 |
| Hispanic male |
15,019 |
6.4 |
35.3 |
12.6 |
| Black male |
14,623 |
6.2 |
24.6 |
8.6 |
| White male |
83,064 |
35.2 |
15.4 |
30.5 |
| Other male |
4,768 |
2.0 |
20.2 |
2.3 |
| Hispanic female |
14,089 |
6.0 |
31.2 |
10.5 |
| Black female |
16,375 |
6.9 |
19.9 |
7.8 |
| White female |
83,235 |
35.2 |
12.8 |
25.4 |
| Other female |
5,040 |
2.1 |
19.9 |
2.4 |
| Marital statusb |
| Married |
92,575 |
39.2 |
13.7 |
30.3 |
| Widowed |
3,071 |
1.3 |
23.1 |
1.7 |
| Divorced |
18,655 |
7.9 |
21.7 |
9.7 |
| Separated |
4,638 |
2.0 |
28.8 |
3.2 |
| Never married |
53,414 |
22.6 |
26.3 |
33.5 |
| Census region |
| Northeast |
44,517 |
18.8 |
14.3 |
15.2 |
| Midwest |
55,004 |
23.3 |
13.0 |
17.0 |
| South |
82,594 |
35.0 |
21.4 |
42.0 |
| West |
54,100 |
22.9 |
20.0 |
25.8 |
| Perceived health
status |
| Excellent |
88,319 |
37.4 |
15.9 |
33.5 |
| Very good |
74,463 |
31.6 |
16.3 |
29.0 |
| Good |
52,443 |
22.2 |
20.8 |
26.0 |
| Fair |
15,459 |
6.6 |
23.2 |
8.6 |
| Poor |
5,283 |
2.2 |
22.8 |
2.9 |
- a Includes persons with unknown
employment status and marital status.
- b For individuals age 16 and
over.
Note: Percents may not add to 100
because of rounding.
Source: Center for Financing, Access,
and Cost Trends, Agency for Healthcare Research and Quality:
Medical Expenditure Panel Survey Household Component, 1998.
^top
References
Cohen JW, Monheit AC, Beauregard KM, et
al. The Medical Expenditure Panel Survey: a national health
information resource. Inquiry 1996;33:373-89.
Cohen S. Sample design of the 1996 Medical
Expenditure Panel Survey Household Component. Rockville (MD):
Agency for Health Care Policy and Research; 1997. MEPS Methodology
Report No. 2. AHCPR Pub. No. 97-0027.
Lefkowitz D, Monheit AC. Health insurance,
use of health services, and health care expenditures. Rockville
(MD): Agency for Health Care Policy and Research; 1991. National
Medical Expenditure Survey Research Findings 14. AHCPR Pub.
No. 92-0017.
U.S. Congress, Office of Technology Assessment.
Does health insurance make a difference? Background paper.
Washington: U.S. Government Printing Office; 1992. Report
No. OTA-BP-H-99.
Vistnes JP, Monheit AC. Health insurance
status of the civilian noninstitutionalized population: 1996.
Rockville (MD): Agency for Health Care Policy and Research;
1997. MEPS Research Findings No. 1. AHCPR Pub. No. 97-0030.
Vistnes JP, Zuvekas SH. Health insurance
status of the civilian noninstitutionalized population: 1997.
Rockville (MD): Agency for Health Care Policy and Research;
1999. MEPS Research Findings No. 8. AHCPR Pub. No. 99-0030.
^top
Appendix
This data in this report
were obtained in the third round of interviews for the Household
Component (HC) of the 1997 Medical Expenditure Panel Survey
(MEPS) and the first round of interviews from the 1998 MEPS
HC. MEPS is cosponsored by the Agency for Healthcare Research
and Quality (AHRQ) and the National Center for Health Statistics
(NCHS). The MEPS HC is a nationally representative survey
of the U.S. civilian noninstitutionalized population that
collects medical expenditure data at both the person and household
levels. The focus of the MEPS HC is to collect detailed data
on demographic characteristics, health conditions, health
status, use of medical care services, charges and payments,
access to care, satisfaction with care, health insurance coverage,
income, and employment. In other components of MEPS, data
are collected on the use, charges, and payments reported by
providers; residents of licensed or certified nursing homes;
and the supply side of the health insurance market.
The sample for the MEPS HC was selected
from respondents to the National Health Interview Survey (NHIS),
which was conducted by NCHS. NHIS provides a nationally representative
sample of the U.S. civilian noninstitutionalized population
and reflects an oversampling of Hispanics and blacks. The
MEPS HC collects data through an overlapping panel design.
In this design, data are collected through a precontact interview
that is followed by a series of five rounds of interviews
over 2 1/2 years. Two calendar years of medical expenditure
and utilization data are collected from each household and
captured using computer-assisted personal interviewing (CAPI).
This series of data collection rounds is launched again each
subsequent year on a new sample of households to provide overlapping
panels of survey data which, when combined with other ongoing
panels, will provide continuous and current estimates of health
care expenditures. The reference period for Round 3 of the
1997 MEPS HC (Panel 2) was from the Round 2 interview date
to the Round 3 interview date. The reference period for Round
1 of the 1998 MEPS HC (Panel 3) was from January 1, 1998,
to the date of the Round 1 interview. Interviews for Panel
2 (Round 3) and Panel 3 (Round 1) were conducted from March
to July 1998.
Derivation of Insurance Status Information
The household respondent was asked if during
the interview period anyone in the family was covered by any
of the sources of public and private health insurance coverage
discussed in the following paragraphs. For respondents in
their third MEPS interview (Panel 2), previously reported
insurance was reviewed to determine whether it was still in
effect and when changes in insurance status had occurred.
Although Panel 2 survey respondents were asked about their
insurance information for part of 1997 as well as 1998, the
insurance information in this report refers to coverage only
in 1998. Medicare and TRICARE coverage were measured at the
time of the interview. (TRICARE, the present military coverage,
replaced CHAMPUS and CHAMPVA.) All other sources of insurance
were measured for any time between January 1998 and the interview.
Persons counted as uninsured were uninsured throughout this
time period.
Public Coverage
For this report, individuals were considered
to have public coverage only if they met both of the following
criteria:
- They were not covered by private insurance.
- They were covered by one of the public
programs discussed below.
Medicare
Medicare is a federally financed health
insurance plan for the elderly, persons receiving Social Security
disability payments, and most persons with end-stage renal
disease. Medicare Part A, which provides hospital insurance,
is automatically given to those who are eligible for Social
Security. Medicare Part B provides supplementary medical insurance
that pays for medical expenses and can be purchased for a
monthly premium.
Tricare
TRICARE covers active-duty and retired members
of the Uniformed Services and the spouses and children of
active-duty, retired, and deceased members. Spouses and children
of veterans who died from a service-connected disability or
who are permanently disabled and not eligible for Medicare
are covered by TRICARE. In this report, TRICARE coverage is
considered to be public coverage. When persons covered by
TRICARE reach age 65, their coverage generally ends and enrollees
are eligible for Medicare.
Medicaid
Medicaid is a means-tested government program
jointly financed by Federal and State funds that provides
health care to those who are eligible. Program eligibility
criteria vary significantly by State, but t |
