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Medical Expenditure Panel Survey 

Agency for Health Care Policy and Research

Briefly stated:

During the first half of 1996, 83 percent

of Americans, 218.8 million people, had

some type of private or public health

insurance coverage.About 68 percent had

private health insurance; 15 percent were

covered only by Medicare, Medicaid, or

other public sources; and the remaining 17

percent were uninsured.

Nearly 61 percent of the population had

job-related coverage. Employment-based

coverage represented more than 89

percent of all private insurance.

Nearly 69 percent of people under 65

years of age were covered by private

insurance, 12 percent were covered by

public insurance, and 19 percent were

uninsured.

Groups at high risk of being uninsured

included racial/ethnic minorities

(particularly Hispanic males), young adults

ages 19-24, and people under 65 who

were in good or fair health.

Health Insurance Coverage

in America—1996

Estimates for the U.S. Civilian

Noninstitutionalized Population 

Introduction

Compared to people without health care

coverage, insured people are more likely to have a

regular source of medical care and to spend less out

of pocket on health services. Moreover, insured and

uninsured people experience different treatment

patterns, quality, and continuity in their health care.

Medical Expenditure Panel Survey (MEPS) data

show that 83 percent of Americans, 218.8 million

people, had some type of private or public

insurance coverage during the first half of 1996.

Roughly 68 percent had private health insurance,

while approximately 15 percent were covered only

by Medicare, Medicaid, or other public sources. The

remaining 17 percent of the population were

uninsured. Nearly 61 percent of the population had

job-related coverage. Coverage through the

workplace represented more than 89 percent of all

private insurance. This Highlights describes the

distribution of health insurance according to

demographic characteristics such as age and

race/ethnicity.

May 1998

Number 4
MEPS Definitions of

Private and Public

Insurance

Private health insurance is defined as

insurance that provides coverage for

hospital and physician care.

Insurance that provides coverage for

a single service only, such as dental

or vision coverage, is not counted as

private insurance.

Individuals are considered to have

public insurance if they have

coverage only under Medicare,

Medicaid, CHAMPUS/CHAMPVA

(Civilian Health and Medical

Programs for the Uniformed

Services and Veterans’Affairs), or

some other type of public hospital

and physician coverage.

Age

Of persons under 65 years of age,

69 percent had private insurance coverage, 12 percent had public coverage, and

19 percent were uninsured.

In general, children under age 18

are more likely than adults to be

insured. Public insurance plays a key

role in insuring low-income children.

One in four children under age 4, nearly

the same proportion ages 4-6, and one

in five children ages 7-12 obtained

public coverage, usually through

Medicaid. Despite the existence of the

Medicaid safety net, however, 11

million children lacked health insurance

coverage.

Young adults ages 19-24 had the

highest risk of being uninsured

(Figure 1). Over a third of them (38

percent) were uninsured, more than

twice the rate for all Americans. Two

partial explanations of the low rate of

insurance among this age group are the

fact that young adults who are not fulltime students are likely to lose

dependent coverage on their parents’

plans and the tendency of young people

to be employed in transitory or lowwage jobs that do not offer health

insurance coverage. Although they

comprised less than a tenth of the nonelderly population, young adults

represented nearly a fifth of the

uninsured population. They also had the

lowest rates of private insurance

coverage.

MEPS data also show that, although

6 out of 10 elderly Americans were

covered by private insurance (almost

always in addition to Medicare), nearly

4 out of 10 were covered only by public

insurance (Medicare only or Medicare

in conjunction with Medicaid or another

public source).

Race/Ethnicity

Figure 2 shows that no more than

half of all Hispanic and black

Americans under age 65 (45 and 50

percent, respectively) were covered by

private health insurance, compared to

more than three-quarters of whites (77

percent). Hispanic and black Americans

were more than twice as likely as white

Americans to be covered by public

health insurance, although they also

were more likely to be uninsured.

Young adults ages 19-24 were the

non-elderly age group most at risk of

TWO

Figure 1. Risk of being uninsured by age:

First half of 1996

DATA SOURCE:

1996 Medical

Expenditure Panel

Survey Household

Component,

Round 1.

Young adults ages

19-24 were the age

group most likely to

lack health

insurance. Over a

third of young adults

were uninsured,

more than twice the

rate for all

Americans.

0

5

10

15

20

25

30

35

40

65

& over Under 18 19-24 25-29 30-34 35-54 55-6418

15.4%

28.4%

37.8%

26.8%

19.3%

16.4%

14.7%

0.9%
lacking private insurance and of being

uninsured. There are also striking

disparities in health insurance coverage

when racial/ethnic background is

considered. Half of all Hispanic and

black young adults were uninsured (53

percent and 50 percent, respectively)

compared to 31 percent of white young

adults. In addition, white young adults

were significantly more likely to obtain

private insurance and less likely to rely

on public insurance than their Hispanic

and black counterparts.

Health Status

Non-elderly persons in fair or poor

health were less likely than those in

better health to have private insurance

(Figure 3). However, public insurance

helped reduce the health-related

disparities in private coverage. Nearly

25 percent of persons in fair health and

almost 40 percent of persons in poor

health obtained public coverage.

About MEPS

The Medical Expenditure Panel

Survey (MEPS) collects nationally

representative data on health care use,

expenditures, source of payment, and

insurance coverage for the U.S. civilian

noninstitutionalized population. MEPS

is cosponsored by the Agency for

Health Care Policy and Research and

the National Center for Health

Statistics. This Highlights summarizes

data concerning the distribution of

insurance coverage in the United States

during the first half of 1996, as derived

from the MEPS Household Component,

Round 1. For more information about

MEPS, see the sources listed on the

back page.

Figure 2. Race/ethnicity and health

insurance status: First half of 1996

Hispanic and black

Americans were

less likely than

white Americans to

be privately insured,

but they were more

likely to have public

insurance.

THREE

The proportion of

persons without any

insurance did not

vary greatly among

health status groups

because those in

poorer health were

more likely to be

covered by public

insurance.

DATA SOURCE:

1996 Medical

Expenditure Panel

Survey Household

Component,

Round 1.

Figure 3. Perceived health status and

health insurance status of the population

under age 65: First half of 1996

Private insurance

Public insurance

Uninsured

Hispanic Black White

Hispanic Black White

44.6%

20.3%

35.1%

49.9%

25.2%

24.8%

76.7%

8.1%

15.2%

36.5%

10.6%

52.8% 34.9%

14.9%

50.2%

62.5%

6.3%

31.1%

Under age 65

Ages 19-24

0

20

40

60

80

100

Private insurance

Public insurance

Uninsured

Excellent Very good Good Fair Poor

74.4% 73.1% 62.3% 50.1% 38.8%

8.2% 10.1%

14.9%

24.9% 39.8%

17.4% 16.9% 22.8% 25.1% 21.4%
U.S. Department of Health and Human Services

Public Health Service

Agency for Health Care Policy and Research

2101 East Jefferson Street, Suite 501

Rockville, MD 20852

Medical Expenditure Panel Survey 

Health Insurance Coverage in

America—1996

For more information on MEPS, call the MEPS

information coordinator at AHCPR (301/594-

1406) or visit the MEPS section of the AHCPR

Web site at 

http://www.ahcpr.gov/

For a detailed description of the MEPS survey

design, sample design, and methods used to

minimize sources of nonsampling error, see the

following publications:

Cohen J. Design and methods of the Medical

Expenditure Panel Survey Household

Component. Rockville (MD): Agency for

Health Care Policy and Research; 1997. MEPS

Methodology Report No. 1. AHCPR Pub. No.

97-0026.

Cohen S. Sample design of the 1996 Medical

Expenditure Panel Survey Household

Component. Rockville (MD): Agency for

Health Care Policy and Research; 1997. MEPS

Methodology Report No. 2. AHCPR Pub. No.

97-0027.

The estimates in this Highlights are based on

the following, more detailed publication: 

Vistnes JP, Monheit AC. Health insurance

status of the civilian noninstitutionalized

population: 1996. Rockville (MD): Agency for

Health Care Policy and Research; 1997. MEPS

Research Findings No. 1. AHCPR Pub. No. 97-

0030.

These publications are available from the

AHCPR Clearinghouse (800/358-9295) and

through the AHCPR Web site.

http://www.ahcpr.gov/ Look for the MEPS Web site at:

AHCPR Pub. No. 98-0031

May 1998