Going bare: trends in health insurance coverage, 1989 through 1996

Am J Public Health. 1999 Jan;89(1):36-42. doi: 10.2105/ajph.89.1.36.

Abstract

Objectives: This study analyzed trends in health insurance coverage in the United States from 1989 through 1996.

Methods: Data from annual cross-sectional surveys by the US Census Bureau were analyzed.

Results: Between 1989 and 1996, the number of uninsured persons increased by 8.3 million (90% confidence interval [CI] = 7.7, 8.9 million). In 1996, 41.7 million (90% CI = 40.9, 42.5 million) lacked insurance. From 1989 to 1993, the proportion with Medicaid increased by 3.6 percentage points (90% CI = 3.1, 4.0), while the proportion with private insurance declined by 4.2 percentage points (90% CI = 3.7, 4.7). From 1993 to 1996 private coverage rates stabilized but did not reverse earlier declines. Consequently, the number uninsured continued to increase. The greatest increase in the population of uninsured [corrected] was among young adults aged 18 to 39 years; rates among children also rose steeply after 1992. While Blacks had the largest percentage increase, Hispanics accounted for 36.4% (90% CI = 32.3%, 40.5%) of the increase in the number uninsured. From 1989 to 1993, the majority of the increase was among poor families. Since then, middle-income families have incurred the largest increase. Northcentral and northeastern states had the largest increases in percent uninsured.

Conclusions: Despite economic prosperity, the numbers and rates of the uninsured continued to rise. Principally affected were children and young adults, poor and middle income families, blacks, and Hispanics.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Censuses
  • Child
  • Cross-Sectional Studies
  • Data Collection
  • Ethnicity / statistics & numerical data
  • Female
  • Humans
  • Income / statistics & numerical data
  • Income / trends
  • Insurance, Health / statistics & numerical data*
  • Insurance, Health / trends*
  • Male
  • Medicaid / statistics & numerical data
  • Medically Uninsured / statistics & numerical data*
  • Medicare / statistics & numerical data
  • Middle Aged
  • Private Sector / statistics & numerical data
  • Racial Groups
  • Residence Characteristics
  • United States