By Phyllis Griffin Epps
According to the U.S. Census Bureau, the number of Americans without health insurance is high and climbing. Nearly 44.3 million people in the United States, or 16.3% of the population, were without health insurance coverage in 1998. Texas leads the nation with 24.5% of its residents uninsured. In these times of unparalleled economic prosperity, these numbers should shock and alarm.
Traditional indicators highlight the health of the American economy. The stock market has soared to unprecedented heights at a rate no one could have predicted even fifteen years ago. Manufacturing, housing starts, and retail sales all suggest that today's Americans live in an economic environment with resources available to meet their needs, yet the ranks of the uninsured have increased by nearly one million since 1997. The measure of persons without health insurance is an economic indicator Americans cannot afford to ignore.
Employment is the leading source of health insurance coverage according to the U.S. Census Bureau. See http://www.census.gov/hhes/hlthins/hlthin98. Family income levels are higher than ever, and unemployment rates are the lowest in three decades. Evidence suggests, however, that many employers have cut health benefits for employees and their dependents. Employers increasingly require employees to pay higher premiums for coverage, and low-income workers cannot afford the expense. The Census Bureau reports that nearly one-half, or 47.5%, of poor, full-time workers were uninsured in 1998. Keeping in mind the cyclical nature of any economy, what developments can we expect with the economic downturn which will certainly come in the future? What does the future hold when a wealthy society in a time of prosperity is unwilling or unable to assist in safeguarding the health of those least able to obtain coverage without assistance?
As the cliché goes, think of the children. Health care coverage among children has not improved despite legislation enacted for that purpose. Eleven million children and teenagers are without health insurance, the U.S. Department of Education reports. http://www.ed.gov/offices/OUS/chip. In 1997, Congress created the Children's Health Insurance Program (CHIP), which provides health coverage for children whose families earn too much to be eligible for Medicaid but not enough to afford private insurance. Through CHIP, states are slated to receive more than $39 billion over ten years. The number of uninsured children has not changed significantly since 1997, however. Only 1.3 million of six million eligible children have enrolled in CHIP. In August, the Clinton Administration announced the start of a federal investigation to determine whether states have improperly excluded people from CHIP or Medicaid. Meanwhile, uninsured children are more likely to suffer from asthma, ear infections, vision problems, and other treatable conditions that result in higher school absentee rates and otherwise interfere with learning.
Neither have states taken advantage of federal funds allotted for guaranteeing Medicaid coverage to people who lose welfare benefits. Congress provided $500 million to states for administrative costs associated with the changes in welfare laws of 1996. Many people who left the welfare rolls lost Medicaid coverage without getting a replacement. States have the discretion to expand Medicaid eligibility to low-income families who no longer qualify for welfare. To date, however, states have spent only $39 million. Twenty-nine states will lose eligibility for the money at the end of this year.
It remains to be seen whether the measures taken by state and federal governments will prove effective. Results to date are not promising. The number of uninsured climbs ever upward and threatens the health of the nation both literally and figuratively. To ignore this threat by failing to take drastic action in good times is foolhardy.