For Release on Delivery

Expected at 2:30 p.m.

Tuesday, March 13, 2001

GAO-01-507T

HEALTH INSURANCE

Characteristics and Trends

in the Uninsured

Population

Statement of Kathryn G. Allen, Director

Health Care—Medicaid and Private Health Insurance Issues

Testimony

Before the Committee on Finance, U.S. Senate

United States General Accounting Office

GAO
Page 1 GAO-01-507T

Mr. Chairman and Members of the Committee:

I am pleased to be here today as the Committee considers strategies to

address the problem of Americans lacking health insurance. Given the risk

of catastrophic illness or injury, which can devastate families financially,

as well as the importance of access to effective preventive care, health

insurance is critical from an individual and social perspective.

Nevertheless, more than 1 in 6 nonelderly Americans are today uninsured.

The lack of insurance coverage does not affect all Americans equally,

varying widely among demographic subgroups as well as geographically.

To better understand the extent of the problem, my remarks today will

focus on

• the number of uninsured individuals and recent trends,

• the employment and income status and other demographic characteristics

of persons who are more likely to be uninsured, and

• the variation among states in uninsured rates.

My comments are based on our ongoing analyses of the Bureau of the

Census’ Current Population Series, March Supplements, 1995 to 2000; our

work on the private insurance market; and other published research.

In summary, an estimated 42.1 million Americans were uninsured in 1999,

representing 17.4 percent of the nonelderly population. Although down

from a high of 43.9 million in 1998 (18.4 percent), the number of uninsured

Americans had risen steadily for over a decade.1 This increase has taken

place in spite of gradual but steady gains in the share of Americans with

employment-based coverage, and also was accompanied by slight

decreases in public sources of coverage such as Medicaid, the federal-state

health financing program for low-income, aged, and disabled people. More

recently, between 1998 and 1999 the number of Medicaid beneficiaries has

begun to stabilize. This stabilization, in conjunction with the continued

increase in employment-based coverage and the implementation of the

new State Children’s Health Insurance Program (SCHIP), has contributed

to the slight decrease in the number of uninsured, particularly children, in

1999.

 1For information on trends in the uninsured population as well as employment-based and Medicaid

coverage from 1980 to 1995, see Private Health Insurance: Continued Erosion of Coverage Linked to

Cost Pressures (GAO/HEHS-97-122, July 24, 1997).

Health Insurance: Characteristics and

Trends in the Uninsured Population
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 2 GAO-01-507T

Although most nonelderly Americans obtain health insurance through

employment, three-fourths of all uninsured adults are in fact employed.

However, certain types of workers are less likely to have employmentbased insurance available and thus are more likely to be uninsured. In

particular, those working part-time, for small firms, or in certain industries

such as agriculture or construction were among the most likely to be

uninsured. Not surprisingly, persons with low incomes are most likely to

be uninsured, with most uninsured individuals in families earning less than

200 percent of the federal poverty level (which was about $34,000 for a

family of four in 1999). Public programs like Medicaid and SCHIP cover

many low-income individuals, but significant numbers of low-income

children and adults eligible for these programs are not enrolled. Moreover,

other low-income individuals (particularly childless adults) are typically

not eligible. While low-income individuals are most likely to be uninsured,

8 percent of those earning more than 4 times the federal poverty level are

also uninsured. Other populations with a disproportionately high

uninsured rate include young adults, Hispanics, and immigrants,2 in part

because of their type of employment, relatively low incomes, or

ineligibility for public programs.

The share of people who are uninsured varies considerably across states,

ranging from less than 10 percent to nearly 27 percent of all nonelderly

residents in a state. Generally, southern and western states have higher

uninsured rates. States with high uninsured rates and those with low rates

often are distinct with regard to several demographic, employment, and

economic characteristics. Specifically, states with higher than average

uninsured rates tend to have higher unemployment, proportionally fewer

employers offering coverage to their workers, and larger than average

populations of low-income residents, Hispanics, and immigrants than

states with lower uninsured rates.

The availability of health insurance enhances access to preventive,

diagnostic, and treatment services and also provides financial security

against potential catastrophic costs associated with medical care. As a

result, lacking health insurance coverage can have important adverse

health and financial consequences. Research has demonstrated that

uninsured individuals are less likely to have a usual source of care, are

more likely to have difficulty in accessing health care, and generally have

lower utilization rates for all major health care services. For example, the

uninsured are particularly likely to forego services such as periodic check-

 2For analysis purposes, we defined immigrant as any non-native-born resident.

Background
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 3 GAO-01-507T

ups and preventive services, well-child visits, prescription drugs,

eyeglasses, and dental care. As a result, individuals not covered by health

insurance can require acute, costly medical attention for conditions that

may be preventable with early detection and/or treatment. For example,

studies3 have found that

• the uninsured are hospitalized at least 50 percent more often than the

insured for “avoidable hospital conditions” like pneumonia and

uncontrolled diabetes;

• uninsured people with various cancers are more likely diagnosed with

later-stage cancer than individuals with insurance; and,

• uninsured pregnant women receive prenatal care later in their pregnancy

and have fewer doctor visits than the privately insured and, as a result,

their newborn infants have a 31 percent greater risk for adverse health

outcomes such as physical disability or mental retardation.

In addition, individuals without health insurance create a public cost

because of their higher proportion of hospital emergency room visits.

Uninsured adults are 4 times and uninsured children 5 times more likely to

use the emergency room, compared with the insured. Costs for the

uninsured are often absorbed by providers, passed on to the insured

through increased fees and insurance premiums, or underwritten with

public funds to support public hospitals and finance public insurance

programs.

Most nonelderly Americans obtain private health insurance coverage

through employment or by purchasing insurance on their own, and public

programs provide coverage for certain low-income and disabled

individuals. Since World War II, many employers have voluntarily

sponsored health insurance as a benefit to employees for purposes of

recruitment and retention. The federal tax code provides incentives for

employers to subsidize health benefits because their contributions can be

deducted as a business expense, and these contributions are not

considered taxable income for employees. Public programs such as

Medicaid and SCHIP cover certain low-income and disabled individuals.

However, not all low-income individuals are eligible for these public

programs because eligibility is often restricted to selected groups such as

 3For more information, see No Health Insurance? It’s Enough to Make You Sick—Scientific Research

Linking the Lack of Health Coverage to Poor Health (Philadelphia, Pa.: American College of

Physicians—American Society of Internal Medicine), and Uninsured in America—A Chart Book, 2nd ed.

(The Kaiser Commission on Medicaid and the Uninsured, May 2000).
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 4 GAO-01-507T

children, pregnant women, or disabled individuals. Medicare, though

primarily a source of health coverage for elderly Americans, also covers

certain disabled nonelderly individuals.

After more than a decade of steady growth, the number of uninsured

declined slightly in 1999. Between 1994 and 1998, the number of uninsured

Americans grew steadily from 39.4 million (17.1 percent of the U.S.

nonelderly population) to 43.9 million (18.4 percent), while in 1999 the

uninsured population declined to 42.1 million (17.4 percent). (See fig. 1.)

More Than 42 Million

Americans Were

Uninsured in 1999
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 5 GAO-01-507T

Figure 1: Growth in the Number of Uninsured Americans, 1994-99

Source: GAO analyses of the March 1995 to March 2000 Supplements, Current

Population Survey of nonelderly (under 65).

Trends in the uninsured population are closely related to changes in

employment-based and public programs. (See fig. 2.) Reflective of the

strong economy, the share of the nonelderly population with employmentbased coverage grew slowly throughout the entire 1994 to 1999 period,

increasing from 64.4 to 66.6 percent. Between 1994 and 1998, there was a

decline in the percentage of the nonelderly population covered through

public programs, from 12.9 to 10.8 percent, associated with increases in

the numbers of individuals with employment-based coverage as well as in

the numbers of uninsured. However, from 1998 to 1999, the continued

increase in employment-based coverage, coupled with a stabilization in

publicly supported coverage, largely accounts for the decrease in the

number of uninsured. Notably, the share of children who were uninsured

declined from 15.4 percent to 13.9 percent, representing about 1 million

fewer uninsured children in 1999 than 1998—a change likely related

39.4

40.3

41.4

43.1

43.9

42.1

20

25

30

35

40

45

50

1994 1995 1996 1997 1998 1999

Number (Millions)
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 6 GAO-01-507T

strongly to the implementation of SCHIP.4 The Health Care Financing

Administration reported that nearly 2 million children had enrolled in

SCHIP as of September 1999.

 4While the insurance coverage statistics from the Current Population Survey did not separately

identify SCHIP enrollment, the data do provide some indications of the effects of SCHIP in decreasing

the number of uninsured children. Specifically, the decline in the uninsured among children reported

by the Current Population Survey was predominantly among children in families below 200 percent of

the federal poverty level—the income group targeted by SCHIP—and was accompanied by increases in

the proportion of children with public coverage.
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 7 GAO-01-507T

Figure 2: Changes in Sources of Health Insurance Coverage, 1994, 1998,

and 1999

Note: Some people may receive coverage from several sources. To avoid double

counting, we assigned an individual reporting coverage from two or more sources to one

source, based on a hierarchy in the following order: employment-based, Medicare,

Medicaid, other public, and other private.

Source: GAO analyses of the March 1995, March 1999, and March 2000 Supplements,

Current Population Survey of nonelderly (under 65).

Access to affordable employment-based coverage is the primary means for

nonelderly americans to obtain health insurance, but the availability of this

coverage varies. Most uninsured individuals are employed but working at

small businesses or in certain industries where they are less likely to be

offered coverage and are therefore more likely to be uninsured. Although

public programs cover many low-income individuals, this group is still the

most likely to be uninsured since many either are not eligible for these

programs or are not enrolled even if they are eligible. Furthermore,

disproportionately large shares of young adults, hispanics, and immigrants

are uninsured.

Despite Widespread

Private EmploymentBased and Public

Program Coverage,

Many Workers and

Low-Income

Individuals Remain

Uninsured

64.4

5.6

17.1

12.9

65.8

18.4

5.0

10.8

5.2

10.8

17.4

66.6

Employment-Based

Insurance

Public Insurance Other Private

Insurance

Uninsured

Percentage of Nonelderly

1994

1998

1999

80

70

60

50

40

30

20

10

0
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 8 GAO-01-507T

Although employment-based health insurance is the major source of

coverage and insures two-thirds of nonelderly Americans, a significant

number of workers do not have health insurance because either their

employers do not offer it or they choose not to purchase it. In fact, about

three-quarters of the uninsured population in 1999 worked either full- or

part-time. (See fig. 3.)

Figure 3: Most Uninsured Adults Are Employed (1999)

Source: GAO analysis of the March 2000 Supplement, Current Population Survey of

nonelderly adults (18- to 64-year-olds).

Lack of insurance coverage is more common among certain types of

workers, employers, and industries. Employers often do not offer health

benefits to part-time workers. As a result, part-time workers are almost as

likely to be uninsured as nonworkers, and nearly twice as likely to be

uninsured as full-time workers. Employees of small firms are more likely

to be uninsured than those working for larger firms, with the likelihood of

being uninsured decreasing as the size of the firm increases. Of those

working for firms with fewer than 10 employees, 30 percent were

uninsured in 1999, compared with only about 11 percent of those working

for firms with more than 1,000 employees. (See fig. 4.) In large part this is

because small employers are much less likely to offer health insurance to

their employees than larger employers: only 36 percent of private

establishments with fewer than 10 employees offered health insurance in

Employer Coverage, the

Principal Source of Health

Insurance, Is Not

Universally Available

41.7% Full-Time

Nonworker

24.7%

33.6% Part-Time
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 9 GAO-01-507T

1998, compared with nearly all private establishments with 50 or more

workers.5

Figure 4: Employees of Small Firms More Likely to Be Uninsured (1999)

Source: GAO analysis of the March 2000 Supplement, Current Population Survey of

nonelderly adults (18- to 64-year-olds).

Those working in certain industries are less likely to be offered health

insurance and face a greater risk of being uninsured. In 1999, more than 30

percent of workers in the construction, agriculture, and natural resources

(for example, mining, forestry, and fisheries) industries were uninsured. In

contrast, 10 percent or less of workers in the finance, insurance, real

estate, and public employment sectors were uninsured. (See fig. 5.)

 5Agency for Healthcare Research and Quality, Center for Cost and Financing Studies, 1998 Medical

Expenditure Panel Survey, Insurance Component.

Under 10 10 to 24 25 to99 100 to 499 500 to 999 1,000 or More

Percentage Uninsured

Number of Employees

35

30

25

20

15

10

5

0
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 10 GAO-01-507T

Figure 5: Likelihood of Being Uninsured Varies by Industry (1999)

Source: GAO analysis of the March 2000 Supplement, Current Population Survey of

nonelderly adults (18- to 64-year-olds).

Despite the presence of Medicaid and other public programs that enroll

millions of low-income Americans, many remain uninsured because either

they are ineligible for public coverage (such as most childless adults,

under Medicaid), or they are eligible but do not enroll. In 1999, 35 percent

of individuals in families with incomes below the federal poverty level had

Medicaid as their only source of health coverage, but a similar share were

uninsured. More than half of the uninsured (54 percent) had family

incomes less than 200 percent of the federal poverty level. Lower-income

individuals are less likely to believe purchasing health insurance is

affordable. Nearly three-quarters of uninsured adults surveyed for one

study in 2000 cited the high cost of coverage as a major reason for their

lack of coverage, nearly half of whom cited high costs as the most

Despite the Availability of

Public Programs, the

Likelihood of Being

Uninsured Is Strongly

Related to Income

35 Percentage Uninsured

30

25

20

15

10

5

0

Transportation/Communication/Utilities

Construction

Agriculture/Natural Resources

Wholesale/Retail Trade

Services

Manufacturing

Finance/Insurance/Real Estate

Public Employment
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 11 GAO-01-507T

important reason.6 While low-income individuals were most likely to be

uninsured, about 8 percent of those earning 4 times the federal poverty

level or more (over $68,000 for a family of four) were also uninsured. (See

fig. 6.)

Figure 6: Low-Income Persons Are More Likely to Be Uninsured (1999)

Source: GAO analysis of the March 2000 Supplement, Current Population Survey of

nonelderly (under 65).

 6Uninsured in America—A Chart Book, The Kaiser Commission on Medicaid and the Uninsured.

<100% 100-149% 150-199% 200-299% 300-399% >400%

Income as Percentage of Federal Poverty Level ($17,029 for a Family of Four, 1999)

40 Percentage Uninsured

35

30

25

20

15

10

5

0
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 12 GAO-01-507T

Certain groups—such as young adults, Hispanics, and immigrants—were

disproportionately likely to be uninsured. Young adults, aged 18 to 24,

were more likely than any other age group to be uninsured. (See fig. 7.)

Young adults’ transition to the workforce—often working part-time or for

low wages, changing jobs frequently, and working for small employers—

makes them less likely to be eligible for employment-based coverage.

Moreover, if they are childless they generally are ineligible for public

programs. In addition to being more likely to find insurance less

affordable, young adults may value it less if they are healthy.

Figure 7: Young Adults Most Likely to Be Uninsured (1999)

Source: GAO analysis of the March 2000 Supplement, Current Population Survey of

nonelderly (under 65).

While about half of the 42 million uninsured people in 1999 were white and

non-Hispanic, racial and ethnic minorities faced a significantly greater risk

of being uninsured. About one-third of Hispanics, Native Americans, and

Eskimos were uninsured, compared with just over one-fifth of blacks,

Asians, and Pacific Islanders and one-eighth of whites. (See fig. 8.)

Some Groups

Disproportionately

Uninsured for a Variety of

Reasons

0-17 18-24 25-34 35-44 45-54 55-64

Percentage Uninsured 35

30

25

20

15

10

5

0

Age
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 13 GAO-01-507T

Figure 8: Minorities More Likely to Be Uninsured (1999)

Source: GAO analysis of the March 2000 Supplement, Current Population Survey of

nonelderly (under 65).

Disparities in uninsured rates among racial and ethnic groups are partially,

but not fully, related to income. For example, among individuals with

incomes below the federal poverty level, uninsured rates are similar for

black and white non-Hispanics, but blacks are more likely to be uninsured

than whites within higher income categories. Within all income categories,

Hispanics and other non-black minorities are more likely to be uninsured

than whites. (See table 1.)

Asian/

Pacific Islander 

Native American

/Eskimo 

Hispanic Black White

40 Percentage Uninsured

35

30

25

20

15

10

5

0
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 14 GAO-01-507T

Table 1: Uninsured Rates by Race/Ethnicity and Income, 1999

Percentage uninsured

Income category

(percentage of

federal poverty level) Whitea Blacka Hispanic

Asian, Eskimo,

Native American,

and Pacific

Islandera

Less than 100 percent 32.1 30.5 45.4 43.6

100 to 199 percent 23.0 28.6 42.0 36.3

200 to 299 percent 14.7 22.2 32.8 24.9

300 to 399 percent 9.8 16.0 24.0 20.6

400 percent or more 6.7 12.7 15.8 11.8

a

Only non-Hispanics were included in the white; black; and Asian, Eskimo, Native

American, and Pacific Islander groups.

Source: GAO analysis of the March 2000 Supplement, Current Population Survey of

nonelderly (under 65).

In addition, immigrants are more than twice as likely to be uninsured—

about 37 percent compared with about 15 percent of nonimmigrants. Their

higher uninsured rates are in part because they are more likely to be lowincome and potentially facing legal and other difficulties in obtaining

coverage under public programs such as Medicaid. In 1999, about 20

percent of immigrants from families earning less than the federal poverty

level were covered by Medicaid, compared with nearly 38 percent of

nonimmigrants. Lower Medicaid coverage rates may be related in part to

recent changes in federal law that preclude certain immigrants from

Medicaid and SCHIP eligibility for 5 years after immigrating to this

country.7 Individuals who are undocumented (illegal) aliens are ineligible

for Medicaid and SCHIP coverage regardless of how long they have been

in the country, with the exception of emergency treatment, for which they

are covered under Medicaid. Moreover, undocumented individuals may be

reluctant to seek Medicaid or SCHIP coverage for their citizen children for

fear that program participation by any family members may impact their

ability to remain in the country or sponsor other family members coming

to the United States.

 7Under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, states may not

use federal funds for Medicaid or SCHIP coverage for 5 years for certain immigrants arriving on or

after August 22, 1996. States have the option of providing coverage to such immigrants entirely out of

state funds; however, only about 13 states had done so as of October 2000.
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 15 GAO-01-507T

Health insurance coverage rates vary considerably across the nation.

Generally, uninsured rates are highest in the South and West and lowest in

the Midwest and Northeast. (See fig. 9.) In addition, more populous states

such as Florida and New York tend to have higher rates of uninsured. New

Mexico has the highest uninsured rate at 26.6 percent, while Minnesota

has the lowest at 9.6 percent.

Figure 9: States With High Uninsured Rates Concentrated in South and

West (1998-99)

Source: GAO analyses of the March 1999 and March 2000 Supplements, Current

Population Survey of nonelderly (under 65). Estimates for 1999 and 2000 were combined

to improve the precision of the state-level estimates.

States with high uninsured rates share many employment, economic, and

demographic characteristics, which differ from the characteristics of

Uninsured Rates Vary

Widely Among States

Uninsurance Rate

Higher Than U.S. Average (13)

Same as U.S. Average (9)

Lower Than U.S. Average (29)
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 16 GAO-01-507T

states with low uninsured rates.8 We found that states with higher

uninsured rates tend to have a disproportionate share of low-income,

unemployed, Hispanic, and immigrant residents as well as fewer firms

offering coverage.9 (See table 2.) (See app. I for uninsured rates by state.)

Table 2: States With High Uninsured Rates Share Some Economic and Demographic Characteristics

Economic characteristics Demographic characteristics

State group

Percentage of

nonelderly below

poverty level,

1998-99a

Unemployment

rate, 1999b

Percentage of

private firms

offering

coverage,

1998c

Percentage of

nonelderly

Hispanic

1998-99 a

Percentage of

nonelderly nonnative-born, 1998-99 a

13 states with

significantly higher

uninsured rates 15.6 4.9 50.5 24.5 16.8

9 states with uninsured

rates not significantly

different from the U.S.

average 13.4 4.6 51.6 4.6 4.2

29 states with

significantly lower

uninsured rates 10.3 3.7 55.2 4.8 6.0 a

Source: GAO analyses of pooled Current Population Survey March Supplements for 1999

and 2000. Estimates for 1999 and 2000 were combined to improve precision of the statelevel estimates.

b

Source: Bureau of Labor Statistics’ Local Area Unemployment Statistics’ annual averages

for the civilian noninstitutional population 16 years and older.

c

Source: Agency for Healthcare Research and Quality. Estimates from the 1998 Medical

Expenditure Panel Survey—Insurance Component. Offer rates were not reported

separately for the following 10 states and the District of Columbia: Alaska, Hawaii, Maine,

Mississippi, Montana, Nevada, North Dakota, Rhode Island, South Dakota, and Vermont.

For example, the demographic profiles of both Florida and California—

two large states with higher than average uninsured rates—are strikingly

different from the nation as a whole. These two states have among the

highest percentage of Hispanic and immigrant residents in the nation. The

 8To compare these characteristics across states with high or low uninsured rates, we placed states into

three groups: (1) the 13 states with uninsurance rates significantly higher than the U.S. average (as a

group, averaging 22.9 percent of nonelderly residents uninsured), (2) the 8 states and the District of

Columbia with uninsured rates not significantly different from the U.S. average (as a group, averaging

18.1 percent of nonelderly residents uninsured), and (3) the 29 states with uninsured rates significantly

lower than the U.S. average (as a group, averaging 13.6 percent of nonelderly residents uninsured).

9Other demographic characteristics reviewed but found to be similar for higher and lower uninsured

states include the proportion of black residents and median age for the nonelderly population.
Health Insurance: Characteristics and

Trends in the Uninsured Population

Page 17 GAO-01-507T

proportion of the Hispanic population in 1998-99 was more than two times

greater in California (33 percent) than for the United States as a whole (13

percent). In Florida, immigrants composed more than 17 percent of the

population, higher than the U.S. average of about 10 percent and lower

only than California and New York. Some states with high uninsured rates,

including Florida, Idaho, and Montana, have more of their workers in

industries less likely to offer health insurance and fewer in industries more

likely to offer it. For example, nearly 40 percent of Montana’s workers are

employed by the three industries with the highest uninsured rates

(agriculture, construction, and trade), one-third more than the national

average. Conversely, less than 20 percent of Montana’s workers are in the

three industries with the lowest uninsured rates (manufacturing, finance,

and the public sector), about one-fourth less than the national average.

While the decline in the number of uninsured in 1999 following a long-term

increase in this population is welcome news, it is too early to know

whether this reflects a reversal in the trend. Recent expansions of public

programs, such as the implementation of SCHIP, and the tight labor

market likely contributed to the improved coverage. Even with these

positive factors, the number of uninsured remains high, and any significant

downturn in economic conditions could lead to a resumption in the

growth of their numbers. The uninsured population is a diverse group,

including individuals working in different industries and firms of all sizes

as well as of different income levels, ages, races and ethnicities, and

geographic locations. This heterogeneous nature of the 42 million

uninsured Americans suggests that consideration of a combination of

strategies might be appropriate in any efforts to expand health insurance

coverage.

Mr. Chairman, this concludes my statement. I would be happy to answer

any questions that you or Members of the Committee may have.

For more information regarding this testimony, please contact me at (202)

512-7118 or John Dicken at (202) 512-7043. JoAnne R. Bailey, Paula Bonin,

Randy DiRosa, Betty Kirksey, and Elizabeth T. Morrison also made key

contributions to this statement.

Concluding

Observations

GAO Contacts

and Staff

Acknowledgments
Page 18 GAO-01-507T

1998-99a1994-95a

Difference: 1994-95 to

1998-99

States with uninsured rates significantly above U.S. average, 1998-99

New Mexico 26.6 27.3 -0.7

Texas 26.3 26.7 -0.4

Arizona 25.5 23.1 2.4

California 23.4 23.0 0.4

Louisiana 23.2 22.0 1.2

Nevada 23.2 19.4 3.8

Florida 22.0 21.1 0.9

Montana 21.5 15.3 6.2

Mississippi 20.9 21.3 -0.4

Oklahoma 20.8 21.2 -0.4

West Virginia 20.7 18.7 2.0

Idaho 20.6 15.7 4.9

New Yorka19.1 17.7 1.4

States with rates not significantly different from U.S. average, 1998-99

Arkansasa19.3 20.2 -0.9

Alaska 18.9 13.4 5.5

South Carolina 18.7 16.0 2.7

Georgia 18.6 19.0 -0.4

District of Columbia 18.4 18.8 -0.4

Wyoming 18.3 17.1 1.2

U.S. average 17.9 17.2 0.7

Alabama 17.8 18.8 -1.0

Colorado 17.4 14.8 2.6

North Carolina 17.2 15.8 1.4

States with rates significantly below U.S. average, 1998-99

New Jersey 16.5 15.4 1.1

Illinois 16.2 12.6 3.6

Kentucky 16.2 17.0 -0.8

Maryland 16.2 15.7 0.5

Oregon 16.2 14.4 1.8

Virginia 15.8 14.2 1.6

Washington 15.4 14.0 1.4

North Dakota 15.2 9.5 5.7

Utah 15.2 12.9 2.3

South Dakota 15.0 11.1 3.9

Delaware 14.9 16.3 -1.4

Indiana 14.2 13.1 1.1

Maine 13.9 15.3 -1.4

Michigan 13.6 11.6 2.0

Tennessee 13.5 13.9 -0.4

Appendix I: Percentage of Nonelderly That

Were Uninsured, by State
Appendix I: Percentage of Nonelderly That

Were Uninsured, by State

Page 19 GAO-01-507T

1998-99a1994-95a

Difference: 1994-95 to

1998-99

Kansas 13.0 14.4 -1.4

Connecticut 12.8 11.1 1.7

Wisconsin 12.7 8.9 3.8

Vermont 12.3 12.1 0.2

Ohio 12.1 13.0 -0.9

New Hampshire 11.9 12.4 -0.5

Hawaii 11.8 10.2 1.6

Massachusetts 11.7 13.4 -1.7

Pennsylvania 11.5 11.9 -0.4

Nebraska 11.2 11.1 0.1

Missouri 10.8 15.5 -4.7

Iowa 10.2 12.1 -1.9

Rhode Island 9.8 14.4 -4.6

Minnesota 9.6 9.8 -0.2

a March 1999 and 2000 Supplements were combined, as were the March 1995 and 1996

Supplements, to improve the precision of the state estimates.

b

States are categorized as higher than, similar to, or lower than the U.S. average based on

whether the state-level estimate statistically is significantly different from the U.S. average.

Because smaller states have smaller sample sizes in the Current Population Survey, the

potential sampling error is larger in these states than in larger states. Thus, a specific

uninsured rate may be significantly different from the U.S. average for one state but not for

another with a smaller population and sample size. For this reason, New York’s uninsured

rate of 19.1 percent is significantly higher than the U.S. average, even though it is slightly

lower than Arkansas’ estimated rate of 19.3 percent, which is not significantly different

from the U.S. average.

Source: GAO analyses of pooled Current Population Survey March Supplements for 1999

and 2000 and for 1995 and 1996 for the nonelderly population (under 65).

(201099)
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