Myths Regarding Uninsured Americans

Recently, the Henry J. Kaiser Family Foundation, under the auspices of the Kaiser Commission on Medicaid and the Uninsured, published a white paper entitled, "Myths about the Uninsured."

The study clearly revealed that the American public operates with misunderstandings and numerous myths regarding the uninsured in our nation. The Kaiser Commission study debunks the most prominent of the myths.

Here they are!

Myth #1: The uninsured go without coverage because they believe they do not need it or don't want it.

Fact: The majority of uninsured, regardless of how young they are, say they forgo coverage because they cannot afford it, not because they don't need it.

Only 7% of the uninsured report that they don't have health insurance because they don't feel they need it.

Myth #2: Most of the uninsured do not have health insurance because they are not working and so don't have access to health benefits through an employer.

Fact: Most of the uninsured are either working full-time or have someone in their immediate family who does--the problem is that the majority of the uninsured are not offered benefits through their employers.

Eight in ten uninsured Americans come from working families; even at lower income levels, the majority of the uninsured have workers in their families. Eighty-one percent of uninsured workers are employed by firms that do not sponsor health benefits or are not eligible for their employer's plan. Few workers, even low wage workers, turn down health benefits when available.

Myth #3: Most of the growth in the uninsured has been among those with higher incomes.

Fact: The majority of the growth in the uninsured since 2000 has been among people earning less than $38,000 a year for a family of four (commonly considered low-income).

Since 2000, the number of uninsured adults has grown by over 5 million. Nearly 75% of these adults were from low-income families.

Myth #4: Most of the uninsured are new immigrants who are not U. S. citizens.

Fact: The majority of the uninsured (79%) are American citizens.

New immigrants (immigrating less than six years ago) account for only 10% of the uninsured population. New immigrants are at a higher risk of being uninsured compared to citizens, but make up just 3% of the U. S. population, so their contribution to the size of the uninsured population is relatively small.

Myth #5: The uninsured often receive health services for free or at reduced charge.

Fact: Free or even discounted health services are not common and when the uninsured are unable to pay the full costs, the unpaid medical bills add to the providers' costs.

Less than 25% of families with at least one uninsured member report having received care for free or at reduced rates. Charges may actually be higher for the uninsured in comparison to fees negotiated by managed care organizations or set by public payers. The uninsured pay over 40% of the costs for their care out-of-pocket.

Myth #6: The uninsured can get the care they need when they really need it and are able to avoid serious health problems.

Fact: The uninsured are more likely to postpone and forgo care with serious consequences that increase their chances of preventable health problems, disability, and premature death.

Over 33% of the uninsured report needing care in the previous year but not getting it and nearly half of the uninsured report postponing care--rates three times higher than those with insurance. The Institute of Medicine estimates that at least 18,000 Americans die prematurely each year simply because they lack health coverage.

Myth #7: Buying health insurance coverage on your own is always an option.

Fact: Individually purchased policies--vs. job-based group policies with similar benefits--are more expensive and coverage can be limited or even denied to persons with less than good health.

Myth #8: We don't really know how large the uninsured problem is and many are only uninsured for brief periods.

Fact: Depending on whether we count the number of people who are uninsured during a specific month, for an entire year, or just for short periods, the numbers will differ; and all measures are useful.

Experts agree that on any given day of the year the number of uninsured is now about 45 million Americans. Of these, over 75% have been without insurance for more than 12 months. The number of people ever uninsured over the course of a year is much greater than 45 million--by as much as 40%.

Myth #9: The health care the uninsured receive, but do not pay for, results in higher insurance premiums.

Fact: The large majority of uncompensated care is subsidized through a mix of federal and state government dollars not cost shifts to private payers.

Myth #10: Expanding health insurance coverage to all, or even a large share of the uninsured, will cost far more than the country currently spends on health care.

Fact: Because both the uninsured and government subsidies pay for a good share of their health care costs already, the amount of additional health spending to cover all of the uninsured is relatively small.

Most proposals to expand health insurance do not account for the tax dollars currently being used for the care of the uninsured. Best estimates place the additional funds needed to cover all of the uninsured at $48 billion annually.

Health should be seen as an inviolate spiritual value in this nation. Apparently we have a ways to go in this regard.