Government Programs Help Trim the Number of Uninsured Americans

After climbing steadily for the past 20 years, the number of Americans without health insurance dipped in 2007, declining from 47 million in 2006 to 45.7 million last year—or from 15.8 to 15.3 percent of the population—according to new findings of the U.S. Census Bureau.

That recent downward trend, though, is due to more people being enrolled in government programs, offsetting a further drop of those covered by private insurance.

The bureau's annual report, "Income, Poverty and Health Insurance Coverage in the United States 2007," shows that the percentage of people insured under public health programs such as Medicare (for seniors and the disabled) and Medicaid (for low-income people) increased to 27.8 percent in 2007, up from 27 percent in 2006. In contrast, the rate of people with private (mainly employer-based) coverage fell from 67.9 to 67.5 percent over the same 12-month period.

The possibility that government-run health care is increasingly taking a larger role in the nation's insurance coverage is reflected more forcefully in figures encompassing the last 20 years.

Since 1987—when the uninsured totaled 31 million—enrollment in Medicaid has risen by 96 percent, in Medicare by 36 percent and in private insurance by only 11 percent, according to an analysis by Alan Sager and Deborah Socolar, directors of the Health Reform Program at Boston University School of Public Health.

"As a result, the share of the population with private health insurance fell dramatically from 75.6 percent in 1987 to 67.5 percent in 2007," Sager and Socolar said. "Without the rapid rise in Medicaid enrollments during these years, the number of uninsured Americans would have skyrocketed even faster than it did." That's because the 11 percent rise in private insurance enrollment "did not remotely keep pace with U.S. population growth" (24 percent), they said.

Without government programs picking up the slack, the uninsured numbers for 2007 would have surpassed those for 2006, according to Don McCanne, M.D., senior policy fellow of Physicians for a National Health Program, a group of 14,000 doctors in favor of government-run health insurance for all. "The new figure—45.7 million uninsured—is still unacceptably high," he said in a statement. "It's the second-highest figure since the 1960s, when Medicare and Medicaid were enacted."

If a U.S. recession began at the end of 2007, as many economists believe, McCanne added, "it is likely that the Census Bureau figures represent a misleading picture of the current situation."

A recent report from the Center for Economic and Policy Research in Washington suggested that job losses caused by a mild-to-moderate recession could leave an additional 4.2 million Americans without health insurance. The Census Bureau reported that the number of uninsured children under age 18 dropped by 600,000 from 2006 to 2007, a fall that economists attribute to the popularity of SCHIP, the federal-state health insurance program for children. Among Hispanics, the number of uninsured fell by 500,000 in the same period, whereas the number of uninsured African Americans remained unchanged.

Meanwhile, the median household income climbed 1.3 percent, reaching $50,233 in 2007, the bureau reported, but the official poverty rate stayed the same at 12.5 percent of the population.