Agency for Healthcare 

Medical Expenditure Panel Survey Research and Quality 

STATISTICAL BRIEF #84 

June 2005 

The Uninsured in America, 1996–2004: 

Estimates for the U.S. Civilian 

Noninstitutionalized Population under 

Age 65 

Jeffrey A. Rhoades, PhD 

Introduction 

Estimates of the health insurance status of the U.S. civilian noninstitutionalized population are critical to policymakers and others 

concerned with access to medical care and the cost and quality of 

that care. Health insurance helps people get timely access to 

medical care and protects them against the risk of expensive and 

unanticipated medical events. Compared to people with health care 

coverage, uninsured people are less likely to visit a doctor, have a 

usual source of medical care, receive preventive services, or have a 

recommended test or prescription filled.* 

Timely and reliable estimates of the population’s health insurance 

status are essential to evaluate the costs and expected impact of 

public policy interventions in this area, such as efforts to expand 

coverage or to alter the way in which private and public insurance is 

financed. 

The Household Component of the Medical Expenditure Panel Survey 

(MEPS-HC) provides critical information for evaluating trends in the 

health insurance status of the population. This Statistical Brief 

presents estimates on the uninsured in America under age 65 for 

calendar years 1996 through 2003, as well as the first half of 2004. 

All differences between estimates discussed in the text are 

statistically significant at the 0.05 level unless otherwise noted. 

Findings 

MEPS-HC produces estimates of the uninsured for three different 

periods within a year: at any time during the year, throughout the first 

half of the year, or the entire year. In 2003, the latest year for which 

all three measures are available, 25.4 percent of the population 

Highlights 

� The percentage of uninsured 

Americans under age 65 

varied, depending on the 

definition of the time period 

for being uninsured. In 2003, 

25.4 percent of the population was uninsured at some 

point during the year, 18.8 

percent was uninsured 

throughout the first half of 

the year, and 13.6 percent 

was uninsured for the entire 

year. 

� The number of non-elderly 

individuals uninsured for the 

full year increased from 28.7 

million in 1999 to 33.7 million 

in 2003. 

� From 1996 to 2003, the 

number and percentage of 

children under age 18 uninsured all year decreased 

from 7.0 million to 4.6 million 

and from 10.4 percent to 6.6 

percent. 

� The number and percentage 

of children covered by public 

only insurance increased 

between 1996 and 2003 

from 10.9 million to 16.5 

million and from 16.2 

percent to 23.8 percent. 

* Taylor, A., Cohen, J., and Machlin, S. Being uninsured in 1996 compared to 1987: How has the experience of the uninsured 

changed over time? Health Services Research, December 2001: 36(6) Part II:16–31. 

Weinick, R., Zuvekas, S., and Drilea, S. Access to health care—sources and barriers, 1996. MEPS Research Findings No. 3. 

AHCPR Pub. No. 98-000l. Rockville, Md.: Agency for Health Care Policy and Research, 1997. 
under age 65 (non-elderly) was uninsured at some point during the year, 18.8 percent was uninsured 

throughout the first half of the year, and 13.6 percent was uninsured the entire year (figure 1). The 

number of people uninsured varied up to twofold, depending on the time period of being uninsured. In 

2003, 62.9 million non-elderly individuals were uninsured at some point during the year, 47.0 million were 

uninsured throughout the first half of the year, and 33.7 million were uninsured all year (figure 2). 

From 1996 to 2002, the percentage of the population uninsured at some point during the year declined 

from 27.0 percent to 25.3 percent. The percentage uninsured all year declined from 13.8 percent to 12.2 

percent from 1996 to 1999 (figure 1). The number of non-elderly individuals uninsured for the full year 

increased from 28.7 million in 1999 to 33.7 million in 2003 (figure 2). 

For the first half of 2004, the most recent MEPS-HC estimates available, 19.0 percent (48.1 million) of the 

non-elderly population was uninsured (figures 1 and 2). 

From 1996 to 2003, the percentage and number of children (under age 18) who were uninsured declined. 

The percentage of children who were uninsured the entire year declined by 3.8 percentage points, from 

10.4 percent to 6.6 percent (figure 3); and the number of children uninsured for the entire year declined 

by 2.4 million, from 7.0 million to 4.6 million (figure 4). Concurrently, the percentage and number of 

children covered by public only insurance increased 7.6 percentage points (from 16.2 percent to 23.8 

percent, as shown in figure 3) and by 5.6 million (from 10.9 million to 16.5 million, as shown in figure 4). 

On the other hand, the percentage of children with private insurance declined between 1998 and 2003, 

from 60.3 percent to 55.7 percent (figure 3). 

Data Source 

The estimates shown in this Statistical Brief are drawn from analyses conducted by the MEPS staff from 

the following public use files: 1996–2002 full-year consolidated data files (HC-012, HC-020, HC-028, HC038, HC-050, HC-060, HC-070) and 2003 full-year population characteristics data file (HC-073). Point-intime estimates for years 1996–2003 were derived from data files HC-001, HC-005, HC-009, HC-013, HC022, HC-034, HC-053, and HC-064; and from HC-075 (July 2005) for the first half of 2004. 

Definitions 

Uninsured 

People who did not have insurance coverage at any time during the survey year were classified as 

uninsured for the full year. People who did not have coverage during the period from January of the 

survey year through the time of their first interview in that year were classified as uninsured throughout 

the first half of the year. (Interviews were typically conducted from February to June.) People who lacked 

coverage for at least one month during the year were classified in the any time in year category. People 

who were covered only by noncomprehensive State-specific programs (e.g., Maryland Kidney Disease 

Program) or private single service plans (e.g., coverage for dental or vision care only, coverage for 

accidents or specific diseases) were considered to be uninsured. 

Public only coverage 

People were considered to have public only health insurance coverage if they were not covered by 

private insurance and they were covered by Medicare, Medicaid, TRICARE, or other public hospital and 

physician coverage. 

Private coverage 

Private health insurance coverage was defined as nonpublic insurance that provided coverage for 

hospital and physician care (including Medigap coverage). 

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. 
For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

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. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, 

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Rhoades, J. A. The Uninsured in America, 1996–2004: Estimates for the U.S. Civilian Noninstitutionalized 

Population under Age 65. Statistical Brief #84. June 2005. Agency for Healthcare Research and Quality, 

Rockville, Md. http://meps.ahrq.gov/mepsweb/data_files/publications/st84/stat84.htm 
under age 65 

25.4 25.9 25.3 26.8 25.3 24.8 25.9 27.0 

17.8 17.9 18.8 18.5 18.8 19.0 19.2 18.9 18.2 

13.3 13.1 13.1 13.6 12.2 13.3 13.8 13.9

0 

10 

20 

30 

1996 1997 1998 1999 2000 2001 2002 2003 2004 

Any time in year First half of year Full year 

Percent 

Figure 1. MEPS, 1996–2004: Percentage uninsured, 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1996–2003 Full-Year and 1996–2004 Point-in-Time Files 

under age 65 

62.2 61.9 61.7 62.9 59.1 58.5 62.0 61.7

45.9 47.0 48.1 45.7 42.0 42.6 44.5 44.2 43.8 

33.7 32.0 28.7 31.5 31.3 31.6 32.1 31.0

0 

10 

20 

30 

40 

50 

60 

70 

1996 1997 1998 1999 2000 2001 2002 2003 2004 

Any time in year First half of year Full year 

Number in millions 

Figure 2. MEPS, 1996–2004: Number of uninsured, 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1996–2003 Full-Year and 1996–2004 Point-in-Time Files 
55.7 58.3 57.0 56.3

60.3 61.2 58.8 58.8

23.8 23.3 16.2 17.4 16.9 16.4 18.0 20.4

8.2 7.3 6.6 10.4 10.4 9.4 7.7 9.1

0 

10 

20 

30 

40 

50 

60 

70 

1996 1997 1998 1999 2000 2001 2002 2003 

Private Public only Uninsured 

Percent 

Figure 3. MEPS, 1996–2003: Percentage of children 

under age 18, by all-year insurance status 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1996–2003 Full-Year Files 

Number of children under 

38.9 38.6 39.7 39.4 41.4 42.0 40.4 39.8 

16.5 16.1 14.1 10.9 11.6 11.3 11.8 12.4 

5.1 4.6 7.1 6.5 5.3 6.3 5.6 7.0 

0 

10 

20 

30 

40 

1996 1997 1998 1999 2000 2001 2002 2003 

Private Public only Uninsured 

Number in millions 

Figure 4. MEPS, 1996–2003: 

age 18, by all-year insurance status 

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1996–2003 Full-Year Files