Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #40

May 2004 

Health Insurance Coverage and Income 

Levels for the U.S. Noninstitutionalized 

Population under Age 65, 2001 

Highlights 

 Persons under age 65 living 

in middle and high income 

families were much more 

likely to have continuous 

health insurance throughout 

2001 than those in lower 

income households. Slightly 

more than half of persons in

the poor, near poor, and 

low income groups had 

health insurance for the full 

year versus 87.7 percent of

those in the high income 

group and 74.3 percent of 

those in the middle income

group. 

 Approximately one-fourth of 

persons in poor, near poor, 

or low income families were 

not covered by health 

insurance at any time 

during the year. About 20 

percent of individuals in 

these lowest three income 

levels had coverage for part 

of 2001, but not the entire 

year. 

 The higher the family 

income level, the more 

likely it was that a person’s 

insurance came from a 

private, rather than a public, 

source.

Beth Levin Crimmel 

 

Introduction 

In 2001, persons under age 65 who lived in middle or high income 

families were much more likely to have health insurance coverage

for the entire year than those in lower income households. In 

addition, the larger a person’s family income, the more likely 

coverage was to come from private, rather than public, insurance.

This Statistical Brief discusses differences in the sources and 

duration of health insurance coverage by family income level for 

persons under age 65 in the noninstitutionalized population included 

in the Household Component of the Medical Expenditure Panel 

Survey (MEPS-HC) in 2001. MEPS-HC obtains information on both 

private and public health insurance coverage. The survey also 

collects family income data that are compared to poverty-level 

thresholds, which vary by family size and composition, in order to 

determine family poverty status: poor, near poor, low income, middle 

income, or high income. All differences between estimates discussed 

in the text are statistically significant at the 0.05 level. 

Findings 

Slightly more than half of persons under age 65 in the lowest three 

income groups had health insurance for the full-year 2001—54.2 

percent of the poor, 54.8 percent of the near poor, and 53.9 percent

of low income persons (figure 1). In contrast, middle income persons

were much more likely to have full-year coverage (74.3 percent). An 

even higher proportion (87.7 percent) of high income persons were

covered for the full year. 

Roughly one in five persons in the lowest three income categories

had health insurance coverage for part, but not all, of 2001 (figure 2). Part-year coverage was much less 

common in the middle (13.9 percent) and high (6.7 percent) income groups. 

Only 5.5 percent of high income persons and 11.8 percent of middle income persons under age 65 did 

not have any health insurance during 2001 (figure 3). In contrast, about one-fourth of those in the lowest 

three income groups lacked coverage throughout the year. There was little variation between the three 

groups, with low income persons at 24.4 percent, the near poor at 25.5 percent, and the poor at 24.3 

percent. 
Despite the similarity in overall full-year coverage rates within the lowest income groups, the degree to 

which that full-year coverage came from private versus public sources varied substantially. While only 

15.9 percent of persons in poor families had private health insurance for all of 2001, that number rose to 

26.3 percent for the near poor and 39.4 percent for low income persons. In contrast, 68.8 percent of 

middle income persons and 86.4 percent of high income persons had private coverage. 

Persons in poor families with part-year coverage were more likely to have public than private insurance. 

The opposite was true for persons in other income groups. 

Definitions 

The target population for this analysis consists of the U.S. civilian noninstitutionalized population who 

were community residents for all of 2001 and who were under age 65 on December 31, 2001. 

Family

Both family and one-person households are referred to as families in this analysis. See detailed 

definitions used by the U.S. Bureau of the Census at 

http://www.census.gov/population/www/cps/cpsdef.html. 

Health insurance 

Public Coverage: Persons were considered to have public health insurance coverage if they were 

covered by Medicare, Medicaid or the State Children’s Health Insurance Program, TRICARE, or other 

public hospital and physician coverage. 

Private Coverage: Private health insurance coverage was defined for this report as insurance that 

provides coverage for hospital and physician care (including Medigap coverage). Private health insurance 

could have been obtained through an employer, union, self-employed business, directly from an 

insurance company or health maintenance organization (HMO), or through a group or association. 

Duration 

The coverage period is defined as the full calendar year (12 months), part of the calendar year (one to 11 

months), or not at all during the year (zero months). 

Overall, 4.2 percent of persons in the population had some combination of private and public coverage in 

2001. In order to make the public and private designations mutually exclusive, for purposes of this 

analysis each of these persons was identified as having one or the other type of coverage for the year, as 

follows: Persons with continuous full-year public plus part-year private coverage were classified as having 

full-year public insurance; all other persons with a combination of private and public insurance were 

classified based on their private coverage status for the year. Those in the low income group were more 

likely to have a combination of coverage (8.3 percent) during the year than those in the other income 

groups. 

Income 

Family income includes annual earnings from wages, salaries, bonuses, tips, commissions; business and 

farm gains and losses; unemployment and workers’ compensation; interest and dividends; alimony, child 

support, and other private cash transfers; private pensions, IRA withdrawals, social security, and 

veterans’ payments; supplemental security income and cash welfare payments from public assistance, 

Temporary Assistance for Needy Families, and related programs; gains or losses from estates, trusts, 

partnerships, S corporations, rent, and royalties; and “other” income. Family income excludes tax refunds 

and capital gains. 

Poverty-level categories, based on thresholds developed by the U.S. Bureau of the Census

– If family income is less than 100 percent of the poverty-level income, persons in the family are 

considered to be “poor.” (12.0 percent of persons under age 65 in MEPS) 

– If family income is 100 percent or more but less than 125 percent of the poverty-level income, persons 

in the family are considered to be “near poor.” (4.1 percent of persons under age 65 in MEPS) 

– If family income is 125 percent or more but less than 200 percent of the poverty-level income, persons 

in the family are considered to be “low income.” (12.9 percent of persons under age 65 in MEPS) 
– If family income is 200 percent or more but less than 400 percent of the poverty-level income, persons 

in the family are considered to be “middle income.” (31.6 percent of persons under age 65 in MEPS) 

– If family income is 400 percent or more of the poverty-level income, persons in the family are 

considered to be “high income.” (39.4 percent of persons under age 65 in MEPS) 

Data Source 

This Statistical Brief summarizes data on health insurance coverage for different income groups, as 

defined by poverty levels, for the U.S. civilian noninstitutionalized population in year 2001, as derived 

from the MEPS-HC 2001 Full-Year Consolidated File (HC-060).

 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

References 

For a detailed description of the MEPS-HC survey design, sample design, and methods used to minimize 

sources on nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

These publications are available from the AHRQ Clearinghouse (1-800-358-9295) and on the MEPS Web 

site (http://www.meps.ahrq.gov). 

Suggested Citation 

Crimmel, B.L. Health Insurance Coverage and Income Levels for the U.S. Noninstitutionalized Population 

under Age 65, 2001. Statistical Brief #40. May 2004. Agency for Healthcare Research and Quality, 

Rockville, MD. http://www.meps.ahrq.gov/papers/st40/stat40.htm 
Source: Center for Financing, Access,

Medical Expenditure Panel Survey, 2001 

15.9% 

26.3% 

39.4% 

68.8% 

86.4% 

38.3% 

28.5% 

14.5% 

5.4% 

1.3% 

0% 

25% 

50% 

75% 

100% 

Poor Near poor Low income Middle income High income 

Private insurance Public insurance 

54.2% 54.8% 53.9% 

74.3% 

87.7% 

Note: Parts may not sum to total due to rounding. 

 and Cost Trends, AHRQ, Household Component of the 

Figure 1. Percentage of noninstitutionalized persons under age 65 with health 

insurance for full-year 2001, by family income level and source of coverage 
Source: Center for Financing, Access,

Medical Expenditure Panel Survey, 2001 

8.2% 10.0% 

15.9% 

12.1% 

6.7% 

13.3% 9.7% 

5.8% 

1.8% 

0% 

5% 

10% 

15% 

20% 

25% 

Poor Near poor Low income Middle income High income* 

Private insurance Public insurance 

21.5% 

19.7% 

21.7% 

13.9% 

6.7% 

Note: Parts may not sum to total due to rounding. 

 and Cost Trends, AHRQ, Household Component of the 

Figure 2. Percentage of noninstitutionalized persons under age 65 with health 

insurance for part-year 2001, by family income level and source of coverage 

*High income persons with part-year public coverage are combined with those with private coverage 

because the number of persons with part-year public coverage is too small to be broken out separately. 
Source: Center for Financing, Access,

Medical Expenditure Panel Survey, 2001 

15.9% 

26.3% 

39.4% 

68.8% 

86.4% 

8.2% 

10.0% 

15.9% 

12.1% 

6.3% 

38.3% 

28.5% 

14.5% 

5.4% 24.3% 25.5% 24.4% 

11.8% 5.5% 1.7% 

13.3% 9.7% 

1.8% 

5.8% 

0% 

25% 

50% 

75% 

100% 

Poor Near poor Low income Middle income High income* 

Full-year private Part-year private Full-year public Part-year public No coverage 

Note: Parts may not sum to total due to rounding. 

 and Cost Trends, AHRQ, Household Component of the 

Figure 3. Percentage of noninstitutionalized persons under age 65 by length 

and source of health insurance coverage, by family income level, 2001 

*High income persons with part-year public coverage are combined with those with full-year public coverage 

because the number of persons with part-year public coverage is too small to be broken out separately.