Uninsured

Indicator Definition 
Adults (ages 18–64 years) are considered uninsured if they did not have a public or private source of health care coverage for the entire past calendar year.

Adults without health insurance in Colorado6

Adults without health insurance by income in Colorado7

Indicator Significance
The number of uninsured working-age adults in the United States has grown from 30 million in 1999 to 37 million in 2007. Today, roughly one in five working-age Americans is uninsured. Nearly three-quarters of the uninsured are employed, with more than half holding full-time jobs. Research shows that adults without health insurance are less likely to seek medical care when needed. The growing number of uninsured adults has attracted national attention, drawing proposals for reform from state and national policymakers.¹

Colorado Specifics
Colorado has consistently ranked in the lower half of states with regard to insurance coverage for working-age adults. Of the 789,000 uninsured Coloradans, 626,000 are of working age (18-64).² While uninsurance rates are higher for low-income adults, most uninsured adults are employed, many with full-time, year-round jobs. Uninsurance rates are higher for younger working-age adults and ethnic minorities. In 2006 the Colorado General Assembly created a “Blue-Ribbon” Commission on Health Care Reform to develop proposals to expand insurance coverage to as many Coloradans as possible. The Commission reported its recommendations to the General Assembly in early 2008. One cornerstone of the Commission’s vision for reforming the health care system in Colorado is to require all residents to have health insurance coupled with affordable coverage and effective enforcement. This strategy, also known as an “individual mandate,” could significantly increase the number of uninsured who have health insurance.³

Promising Initiatives
In Colorado
Pueblo StepUp is a high value, limited-benefit health care coverage initiative designed to cover Pueblo’s working uninsured. The community pursued this initiative because the city and county have had the highest insurance premiums in the state for several years. Pueblo’s coverage initiative will be financed through contributions from employers, employees and the community.⁴

Elsewhere
Massachusetts has received national attention for its ambitious comprehensive health reform enacted in 2006. The reform includes expansion of Medicaid for children, a requirement that all adults purchase an affordable health insurance plan, and a requirement that most employers offer health insurance to their employees or pay a “Fair Share” contribution of up to $295 annually per employee. The plan includes tax-funded subsidies to help low- and moderate-income residents purchase private insurance and an “Insurance Connector” through which individuals and small employers can purchase standard-benefits insurance. As of August 2008, Massachusetts had the lowest uninsurance rate in the nation, at 8.3 percent.⁵

Adults without health insurance⁸

Text

1. U.S. Census Bureau.
   
   “Census Data on Growing Number of Uninsured Make Clear: National Health Care Strategy is Needed,” August 28, 2007, Commonwealth Fund.
   
   
2. Population estimates in this sentence come from the Current Population Survey (2005 – 2007) and refer to adults ages 18 to 64 years.
   
3. Colorado Blue Ribbon Commission for Health Care Reform Final Report.
   
4. Pueblo StepUp.
   
5. Kaiser Commission on Medicaid and the Uninsured. "Massachusetts Health Care Reform Plan: An Update."
   

Charts

6. Source: Colorado Health Institute analysis of the U.S. Census Bureau’s Current Population Survey, 1999 – 2007.
   
7. Source: Colorado Health Institute analysis of the U.S. Census Bureau’s Current Population Survey, 2005 – 2007.
   
8. Source: U.S. Census Bureau, Current Population Survey, 2005 - 2007.