The Rapidly Rising Number of Uninsured and Underinsured
46.3 Million Americans Have No Health Insurance. “Nationwide, the number of uninsured has increased from 39.8 million in 2001 to 46.3 million in 2008.” [U.S. Department of Health and Human Services, Press Release, 9/16/09]
25 Million Americans Are 'Underinsured.’ “The number of underinsured U.S. adults -- people who have health coverage but are not adequately protected from high medical expenses -- has risen dramatically. A Commonwealth Fund study published by the journal Health Affairs in June finds that as of 2007, there were an estimated 25 million underinsured adults in the U.S., 60 percent more than the 16 million who were underinsured in 2003.” [CommonwealthFund.org, 7/28/08; Accessed, 9/16/09]
14,000 Americans are Losing Their Coverage Each Day. “Even when the economy was growing, 46 million people in America did not have any health insurance. Since the recession began, an estimated 4 million additional Americans have lost their health insurance and 2 million have become uninsured. The recent turmoil in the job market is likely increasing the number of uninsured at the rate of 14,000 a day.” [Center for American Progress, February 19, 2009]
A full one in six Americans with employer-sponsored insurance in 2006 lost that coverage by 2008. If this trend continues, one in six Americans with employer coverage today will lose their job-based health insurance over the next two years. [U.S. Department of Health and Human Services report, “Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage,” accessed, 9/16/09]
Half of all Americans Will Lose Their Health Coverage Sometime in the Next 10 Years. “A new report from the Treasury Department shows that about half of all Americans under age 65 will lose their health coverage at some point over the next ten years. The report also found that more than one-third of Americans will go without coverage for longer than one year.” [Treasury Department, 9/20/09]
More than half of the uninsured—26 million Americans—are small-business owners, employees, or their dependents. Small businesses pay higher premiums than their larger counterparts, and many cannot afford to offer coverage as a result. Among firms with 3 to 9 workers, fewer than half are able to offer health benefits to their workers. [Families USA, July 2009]
Fewer Small Businesses Are Offering Insurance: “From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%.” [U.S. Dept. of Health and Human Services, “Helping the Bottom Line: Health Reform and Small Business,” accessed 9/17/09]
About 10% of small businesses are considering eliminating coverage over the next year, up from 3% in 2005, according to a recent survey by National Small Business Association. [Wall Street Journal, May 26, 2009]
A full 32 percent of working age adults and their families had a gap in health insurance coverage for at least one month in 2006 and 2007. [U.S. Department of Health and Human Services report, “Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage,” Accessed, 9/16/09]
And an estimated 87 million people were uninsured at some point during 2007 and 2008. [U.S. Department of Health and Human Services report, “Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage,” Accessed, 9/16/09]
Exploding Health Care Costs
The Average Family Premium Is $13,375, Up 131% Since 1999. “In 2009, the average annual premiums for employer-sponsored health insurance are $4,824 for single coverage and $13,375 for family coverage. Premiums for family coverage are 5% higher than last year ($12,680)…Since 1999, average premiums for family coverage have increased 131%.” [Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2009, 9/15/09]
Health Care Premiums Cost $1,100 More for the Insured Because of Cost Shifting from the Uninsured. “The Center for American Progress has updated a 2005 analysis by Kenneth Thorpe for Families USA and found that, on average, 8 percent of families’ 2009 health care premiums—approximately $1,100 a year—is due to our broken system that fails to cover the uninsured…The uninsured pay more for care—and get less—than those with insurance. But when the uninsured cannot pay, health care providers shift those costs to those who can pay—those who have insurance coverage. This leads to higher premiums for those who buy their insurance on the individual market, as well as workers who get insurance for themselves and their families through their job.” [Center for American Progress Action Fund report, “The Cost Shift from the Uninsured,” 3/24/09]
Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. [Kaiser Family Foundation; Employer Health Benefits Survey 2008.]
Average family deductible increased 30 percent in just two years. “A deductible is the amount of money a person must pay out of his or her own pocket before health insurance begins to cover the cost of medical expenses. Deductibles have risen substantially over time. For preferred provider organization (PPO) plans purchased through an employer, the average family deductible increased 30 percent in just two years, from $1,034 to $1,344. This effect is more pronounced for small firms, where PPO deductibles increased from $1,439 to $2,367 — a rise of 64 percent.” [U.S. Department of Health and Human Services, “Hidden Costs of Health Care Report: Why Americans Are Paying More But Getting Less,” accessed 9/24/09]
Families Will Be Paying 1/3 of their Income on Health Care Without Reform. “A new report from the Center for American Progress shows that without reform, health care costs will eat up fully one-third of the average family’s income by 2019 – equivalent to a second rent or mortgage payment every month for many families.” [“Family Health Spending to Rise Rapidly,” Center for American Progress, 9/15/09]
Without significant marketplace reforms, if current trends continue, annual health care costs for employers will rise 166 percent over the next decade, from $10,743 per employee today to $28,530 by 2019. [Health Care Reform: The Perils of Inaction and the Promise of Effective Action; A Report to Business Roundtable by Hewitt Associates LLC; September 2009]
If nothing changes, by 2019, total health care spending will reach $4.4 trillion, consuming more than 20 percent of the U.S. Gross Domestic Product. [Health Care Reform: The Perils of Inaction and the Promise of Effective Action; A Report to Business Roundtable by Hewitt Associates LLC; September 2009]
72 million, or 41 percent, of nonelderly adults have accumulated medical debt or had difficulty paying medical bills in the past year. “In fact, one recent survey estimated that 72 million, or 41 percent, of nonelderly adults have accumulated medical debt or had difficulty paying medical bills in the past year. A full 61 percent of those with difficulty had insurance.” [U.S. Department of Health and Human Services report, “Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage,” accessed, 9/16/09]
Nearly three-quarters of Americans who tried to buy health coverage in this market never actually purchased a plan. “Over the last three years, nearly three-quarters of people who tried to buy coverage in this market never actually purchased a plan, either because they could not find one that fit their needs or that they could afford, or because they were turned down due to a preexisting condition.” [The Commonwealth Fund; “Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families,” July 2009]
The Average American Spends About $7500 a year on Health Care. “Health spending in the United States averaged $7,421 per person in 2007, totaling $2.2 trillion, or 16.2% of our nation's economy, up from 7.2% of GDP in 1970 and 12.3% of GDP in 1990.” [Centers for Medicare and Medicaid Services, Office of the Actuary]
Employers Are Spending 131% More On Health Insurance To Cover Their Employees. “Since 1999, family premiums for employer-sponsored insurance have increased 131 percent, while wages have gone up 38 percent and inflation has gone up 28 percent.” [Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2009]
Per Capita Health Spending Has Increased Faster Than The Consumer Price Index. “Over the past 25 years, annual increases in national health spending per capita have exceeded increases in the Consumer Price Index, most recently 5.1% vs. 2.8% in 2007.” [Kaiser Family Foundation calculations using NHE data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group]
The United States Spend Much More on Health Care Coverage Per Person Than Any Other Country. “The U.S. spends substantially more per capita on health care than other developed countries. ($6,567 in the U.S. in 2006 compared to, for example, $4,311 in Switzerland, $4,223 in Luxembourg, $3,505 in Canada, $3,353 in France, $3,247 in Germany, in current health expenditures).” [Organization for Economic Co-operation and Development]
One-Third of all Young Adults Report Problems with Paying Medical Bills. “A lack of adequate coverage also can have devastating consequences for people just starting their financial independence. In a recent survey, more than one-third of all young adults (with or without health insurance) reported problems with paying medical bills, including having trouble making payments, being contacted by a collection agency, or significantly changing their way of life in order to make payments. One in four young adults reported medical debt. This problem is significantly worse for those without insurance. Nearly half of uninsured young adults (49 percent) reported problems with medical bills, and nearly 40 percent carried medical debt. [Young Americans and Health Insurance Reform: Giving Young Americans the Security and Stability They Need; U.S. Dept. of Health and Human Services, accessed 9/22/09]
A 2008 survey found that one in four adults responded that they had passed up another job opportunity, stayed at a job they would have quit, or declined to retire early in order to retain employer-provided health insurance. [Health Care Reform: The Perils of Inaction and the Promise of Effective Action; A Report to Business Roundtable by Hewitt Associates LLC; September 2009]
Between 2000 and 2008, the percentage of firms offering health insurance coverage to their employees declined from 69 to 63; for firms employing less than 10 workers, the decline was even greater – from 57 to 49 percent. [“Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage;” U.S. Department of Health and Human Services, accessed 9/22/09]
Between 2001 and 2005, employers dropping dependent coverage accounted for 11 percent of the decline in employer-sponsored insurance overall. [Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage; U.S. Department of Health and Human Services, accessed 9/22/09]
A family that buys insurance on the individual market pays nearly 60 percent more in out-of-pocket costs such as deductibles and co-payments than a family that gets insurance through work. [Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage; U.S. Department of Health and Human Services, accessed 9/22/09
The Consequences of Doing Nothing: Tens of Thousands Die Each Year Due to Lack of Health Insurance
137,000 Americans Died From 2000 through 2006 Because They Did Not Have Health Insurance. “In 2002, the Institute of Medicine (IOM) estimated that 18,000 Americans died in 2000 because they were uninsured. Since then, the number of uninsured has grown. Based on the IOM’s methodology and subsequent Census Bureau estimates of insurance coverage, 137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006,” according to a January 2008 report from The Urban Institute, “Uninsured and Dying Because of It: Updating the Institute of Medicine Analysis on the Impact of Uninsurance on Mortality.” [The Urban Institute, January 2008]
The Consequences of Doing Nothing: Bankrupt Families
Almost two-thirds of all U.S. bankruptcies are from medical bills. “In 2007, medical problems and expenses contributed to nearly two-thirds of all bankruptcies in the United States, a jump of nearly 50 percent from 2001…Most of those bankrupted by medical problems were "solidly middle class" before they suffered financial disaster -- two-thirds were homeowners and three-fifths had gone to college.” Even those with health insurance had to declare bankruptcy after racking up $17,749 in bills. [American Journal of Medicine, 6/4/09]
Every 90 seconds another family files for bankruptcy due to medical bills. “In 2007, before the current economic downturn, an American family filed for bankruptcy in the aftermath of illness every 90 seconds.” [American Journal of Medicine, 6/4/09]
The Consequences of Doing Nothing: Millions of Americans Avoiding the Care They Need
The results of a recent study showed that two-thirds of the uninsured (68 percent) go without needed care – including seeing a doctor when sick, filling prescriptions, and following up on recommended tests or treatment – and 51 percent of the uninsured report difficulty paying bills, being contacted by collection agencies for unpaid bills, or changing their way of life to pay medical bills. [“Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage;” U.S. Department of Health and Human Services, accessed 9/22/09]
U.S. Health System Ranked # 37 in the World Despite Spending a Higher Portion of GDP Than Any Other Country
"The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance,” according to the June 21, 2000 report “The World Health Report 2000 – Health systems: Improving performance” by the World Health Organization. The same report ranked Costa Rica’s health system #36 and Slovenia’s health system #38. France’s health system was ranked #1. As geographic.org notes, “The World Health Organization's ranking of the world's health systems was last produced in 2000, and the WHO no longer produces such a ranking table, because of the complexity of the task.” [World Health Organization press release, June 21, 2000]
Health Care Costs Doubled From 1996 to 2006, and are Projected to Rise to 25 percent of GDP in 2025. [U.S. Department of Health and Human Services report, “Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage;” HealthReform.gov, accessed 9/16/09]
Health spending in the United States averaged $7,421 per person in 2007, totaling $2.2 trillion, or 16.2% of our nation's economy, up from 7.2% of GDP in 1970 and 12.3% of GDP in 1990. [Kaiser Family Foundation, accessed 9/16/09]
Over the past 25 years, annual increases in national health spending per capita have exceeded increases in the Consumer Price Index, most recently 5.1% vs. 2.8% in 2007. [Kaiser Family Foundation, accessed 9/16/09]
Astronomical Insurance Industry Profits and What They’re Spending to Protect Them
For the five top-earning insurance companies in 2008, average profits were $1.56 Billion; That year, CEO compensation for these companies ranged from $3 million to $24 million. [Families USA, July 2009]
Health Insurance Company CEOs Total Compensation in 2008:
Aetna, Ronald A. Williams: $24,300,112
Cigna, H. Edward Hanway: $12,236,740
Coventry, Dale Wolf: $9,047,469
Health Net, Jay Gellert: $4,425,355
Humana, Michael McCallister: $4,764,309
U. Health Group, Stephen J. Hemsley: $3,241,042
Wellpoint, Angela Braly: $9,844,212
Is It Any Wonder Insurance and HMO Industries Spend Nearly $700,000 Per Day to Kill Health Care Reform Measures; Industries have spent $585.7 million since 2007 on lobbying and campaign contributions. An analysis of insurance and HMO political contributions and lobbying expenses by campaign finance watchdog Public Campaign Action Fund “found the industries spent $126,430,438 over the first half of 2009 and $585,725,712 over the past two and a half years to influence public policy and elected officials. The analysis also “found that in the first part of 2009, the industries were spending money at nearly a $700,000 a day clip to influence the political process and that the monthly pace of political spending this year has increased by nearly $400,000 over the average spent per month in the previous two years.” [Public Campaign Action Fund, press release, 9/15/09]
Negligible Competition in the Private Insurance Market = Higher and Premiums
94% of All Markets Have A Near Monopoly When It Comes to Individual Insurers. “The American Medical Association reports that 94 percent of insurance markets in the United States are now highly concentrated. Shrinking competition among health insurance companies is a major cause of these spiraling costs. In the past 13 years more than 400 corporate mergers have involved health insurers, and a small number of companies now dominate local markets…Contrary to industry assertions, these mergers have undermined market efficiency; premiums have skyrocketed, increasing more than 87 percent, on average, over the past six years.” [American Medical Association, 2008]
Outrageous Insurance Industry Practices
In 45 states, insurance companies can discriminate against people based on their pre-existing conditions when they try to purchase health insurance directly from insurance companies in the individual insurance market. [Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage; U.S. Department of Health and Human Services, accessed 9/22/09]
12.6 Million Americans Seeking Insurance Were Discriminated Against In Last Three Years Because of a ‘Pre-existing Condition. “A recent national survey estimated that 12.6 million non-elderly adults24 – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years. Another study found that among those with a health problem trying to purchase insurance in the individual market, 70 percent found it difficult or impossible to find affordable coverage, and roughly half were turned down or discriminated against. [Insurance Insecurity: Families Are Losing Employer-Sponsored Insurance Coverage; U.S. Department of Health and Human Services, accessed 9/22/09]
In eight states and D.C., it is still legal for insurers to reject a woman’s health insurance application if she is a victim of domestic violence. “The eight states that still allow it are Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota and Wyoming, according to a report by the National Women's Law Center.” [National Women’s Law Center, accessed 9/16/09; Huffington Post, 9/14/09]
20,000 Americans lost their health insurance in the last five years through a shady insurance industry practice called “rescission.” “When a person is diagnosed with an expensive condition such as cancer, some insurance companies review his/her initial health status questionnaire. In most states’ individual insurance market, insurance companies can retroactively cancel the entire policy if any condition was missed – even if the medical condition is unrelated, and even if the person was not aware of the condition at the time. Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition. A recent Congressional investigation into this practice found nearly 20,000 rescissions from three large insurers over five years, saving them $300 million in medical claims – $300 million that instead had to come out of the pockets of people who thought they were insured, or became bad debt for health care providers.” [U.S. Department of Health and Human Services report, “Coverage Denied: How the Current Health Insurance System Leaves Millions Behind; “Pre-Existing Conditions” Affect Millions of Americans,” HealthReform.gov, accessed 9/16/09]
During a 2007 investigation, California regulators uncovered more than 1,200 violations of the law by Anthem Blue Cross in regard to unfair rescission and claims processing practices. “In March 2007, the California Department of Managed Health Care fined Anthem Blue Cross $1 million after an investigation revealed that the insurer routinely canceled individual health policies of pregnant women and chronically ill patients. In order to drop individual policies, the insurer must show that the policyholder lied about their medical history or preexisting conditions on the application. As part of the state’s investigation, regulators randomly selected 90 cases where the insurer had dropped the policyholder. In every single one, investigators found the insurer had violated state law. During the investigation, California regulators uncovered more than 1,200 violations of the law by Anthem Blue Cross in regard to unfair rescission and claims processing practices.” [Americans Association for Justice, “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse,” accessed 9/17/09]
In the past 18 months, California's five largest insurers paid almost $19 million in fines for marooning policyholders who had fallen ill. That includes a $1 million fine against Health Net, which admitted offering bonuses to employees for finding reasons to cancel policies. [Washington Post, September 8, 2009]
One in 10 People with Cancer Unable to Obtain Health Coverage; Six Percent Said They Lost Their Coverage. “In another survey, one in 10 people with cancer said they could not obtain health coverage, and six percent said they lost their coverage, because of being diagnosed with the disease.” [U.S. Department of Health and Human Services report, “Coverage Denied: How the Current Health Insurance System Leaves Millions Behind; “Pre-Existing Conditions” Affect Millions of Americans,” HealthReform.gov, accessed 9/16/09]
California Insurers Deny 1-in-5 Medical Claims for Insured Patients, Even When Recommended by a Patient's Doctor: “More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, amounting to very real death panels in practice daily in the nation's biggest state, according to data released Wednesday by the California Nurses Association/National Nurses Organizing Committee.” [Press release, California Nurses Association, 9/2/2009]
In most states, insurers can reject women for coverage simply for having previously had a Cesarean section (C-section). “In most states, insurers are free to reject individuals applying for coverage in the individual market. Many women face such rejection at this underwriting stage of purchasing insurance for a wide range of reasons. For example, women have greater health needs than men and are more likely than men to suffer from a chronic condition requiring ongoing treatment, like asthma or arthritis. These conditions can lead to rejection of coverage. In addition, if during the medical underwriting process the insurer discovers that an applicant underwent a past C-section, the company may charge her a higher premium, impose an exclusionary period during which it refuses to cover another C-section or pregnancy, or even reject her for coverage altogether unless she has been sterilized or is no longer of childbearing age.” [National Women’s Law Center; Nowhere to Turn: How the Individual Health Insurance Market Fails Women, accessed, 9/17/09]
About 805,000 Californians have insurance policies that specifically exclude maternity coverage. “The number of individual health insurance policies that do not include maternity coverage has risen dramatically in recent years, prompting concern among consumers and a legislative effort to require California insurers to include the benefit. About 805,000 Californians have insurance policies that specifically exclude maternity coverage - a number that has more than quadrupled from 192,000 in 2004, according to the California Health Benefits Review Program, which provides independent analysis of proposed health insurance benefits mandates. Ben Singer, a spokesman for Anthem Blue Cross explained to the San Francisco Chronicle: "Having a child is a matter of choice.” [San Francisco Chronicle, March 24, 2009]
In 33 states, insurance companies are permitted to charge higher premiums based on age, gender, and health status. “In 33 states, insurance companies are permitted to charge higher premiums based on age, gender, and health status without any restrictions whatsoever. Younger women are often charged higher premiums than men during their reproductive years. Holding other factors constant, a 22-year-old woman can be charged one and a half times the premium of a 22-year-old man.” [Young Americans and Health Insurance Reform: Giving Young Americans the Security and Stability They Need; U.S. Department of Health and Human Services, accessed 9/22/09]
Ø Women Pay Up to 48 Percent Higher Premiums Than Men. “NWLC found that among the plans examined, at age 25, women were charged between 6% and 45% more than men for individual market health plans; at 40-years-old, women’s monthly premiums ranged between 4% and 48% higher than men’s monthly premiums. [National Women’s Law Center; Nowhere to Turn: How the Individual Health Insurance Market Fails Women, accessed, 9/17/09]
Ø Premiums can vary as much as 11:1 based on a customer's age. “In some markets today, premiums can vary as much as 11:1 based on a customer's age. That means the oldest customer could pay as much as 11 times more than the youngest customer simply because of his or her age. [New America Foundation; The New Health Dialogue Blog, 9/2/09]
Support for Health Insurance Reform That Includes a Public Option
Three out of four physicians nationwide support inclusion of a public option as part of health insurance reform. “A Robert Wood Johnson Foundation (RWJF) study published in Monday's New England Journal of Medicine shows that 63 percent of physicians support a health reform proposal that includes both a public option and traditional private insurance. If the additional 10 percent of doctors who support an entirely public health system are included, then approximately three out of four physicians nationwide support inclusion of a public option.” [Huffington Post, 9/14/09]
By a 62% to 28% margin, voters support a public option regardless of whether they watched the President Obama’s September 9th address to Congress. [Anzalone Liszt Research memo, 9/12/09]
By a 10-point margin, voters are more likely to re-elect a Member of Congress who votes for healthcare reform [Anzalone Liszt Research memo, 9/12/09]
Majority Of Business Leaders Support a Public Option. A survey, conducted by Anzalone Liszt Research in advance of President Obama's address to Congress, showed that 57% of business leaders believe health care reform should be an important government policy. They support key elements of a reform plan, including…requiring insurance companies to cover pre-existing conditions (79%) and a public health option (51%). [CNBC.com, 9/11/09]
Additional Resources:
“Myths vs. Facts,” AARP: http://aarp.convio.net/site/PageNavigator/Myths_vs_Facts
“ HEALTH CARE MYTHS VS. REALITY,” ThinkProgress.org:
http://wonkroom.thinkprogress.org/wp-content/uploads/2008/03/hc-myth-vs-reality-v3.pdf
For more health insurance reform myth busting, please click here.
For more information on America’s Affordable Health Choices Act, please click here.
