Changes In Insurance Coverage: 1994-2000 And BeyondMary Beth Pohl, John HolahanAlthough the number of Americans with employer coverageincreased dramatically, the rate of uninsurance remainedessentially unchanged. (The full text of this paper isavailable online on the Health Affairs Web site, posted 3April 2002.)ABSTRACT: Despite two consecutive years of declines in the number of uninsured Americans at the end ofthe 1990s boom, essentially the same percentage of the U.S. population was uninsured in 2000 as was in1994 — about 17 percent. This analysis of Census Bureau data by John Holahan andMary Beth Pohl exploresthe trends in insurance coverage during a period of economic expansion in the 1990s.More Americans fell under the umbrella of employer coverage as job rolls expanded and economic prosperitypulled many families up the income ladder. As the low-income population dropped by 8.2 million and themiddle- and highincome populations rose by 2 million and 19.2 million, respectively, the employer coveragerate climbed from 64.2 percent to 67.3 percent.But that expansion masked declines in other types of coverage. Enrollment in Medicaid and otherstate-sponsored insurance programs declined because of welfare reform and the improving economy; manylow-income people obtained higherpaying jobs and received coverage from their employers. Enrollment inprivate nongroup insurance products also fell, which the authors attribute to problems in the individualinsurance market, as well as expansion in employer coverage.The authors also focus on the decline in the number of uninsured persons between 1999 and 2000. Thisreduction has been attributed to the continued expansion of employer coverage. However, increases in thiscoverage for adults were offset by declines in other kinds of coverage. Because public coverage for childrenalso increased, seemingly because of the new State Children's Health Insurance Program (SCHIP), there wasa reduction in the number of uninsured children and an overall decline in coverage for children and adults.The authors warn that if a period of great economic expansion can't budge the uninsurance rate, risingpremiums and higher unemployment rates could reduce employer coverage and raise the number ofuninsured. How many newly uninsured persons there are depends on whether and how much Medicaidenrollment and private nongroup coverage increase. John Holahan is director of the Urban Institute's HealthPolicy Center, and Mary Beth Pohl is a research assistant there.Other Publications by the AuthorsMary Beth Pohl John Holahan Usage and reprints: Most publications may be downloaded free of charge from the web site and may be used and copiesmade for research, academic, policy or other non-commercial purposes. Proper attribution is required. Posting UI researchpapers on other websites is permitted subject to prior approval from the Urban Institute—contact publicaffairs@urban.org.If you are unable to access or print the PDF document please contact us or call the Publications Office at (202) 261-5687.Disclaimer: The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of publicconsideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, itstrustees, or its funders. Copyright of the written materials contained within the Urban Institute website is owned orcontrolled by the Urban Institute. Document date: April 03, 2002Released online: April 03, 2002Source: The Urban Institute, © 2012 | http://www.urban.org