Posted on May 2, 2008

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Commonwealth Fund Releases Two Reports on Healthcare Coverage

The cost to the U.S. public for health insurance coverage and health care for full-time workers and their family members without employer coverage has increased significantly in recent years, while the healthcare spending gap between high- and low-wage workers has widened considerably, two new reports from the Commonwealth Fund find.

The first, Who Pays for Health Care When Workers Are Uninsured? (issue brief 18 pages, PDF), found that the costs of publicly paid health care for full-time workers and families increased from $31 billion in 1999 to $45 billion in 2004. The figure includes public coverage such as Medicaid and the State Children's Health Insurance Program (SCHIP), which cost the public approximately $33 billion in 2004 — up from $21.2 billion in 1999 — while the public cost of uncompensated care expenses provided to uninsured workers and dependents rose from $9.4 billion to $12 billion over the same period.

According to the report, the cost borne by the public for workers not covered by their own employers is largely the result of a decrease in the number of workers and their families who receive coverage through employers. Some nineteen million full-time workers and their dependents were uninsured in 2004, compared with sixteen million in 1999. At the same time, the number of dependents enrolled in public programs increased 83 percent — from six million to eleven million — over the five-year period.

The second report, The Widening Health Care Gap Between High- and Low-Wage Workers (issue brief 14 pages, PDF), found that in 2003 a third of all full-time workers earning less than the twentieth percentile of wages were uninsured for the full year — a 9 percent increase over 1996. In addition to being less likely to have health insurance through their jobs than higher-wage workers, low-wage workers were less likely to have a regular doctor, to go to the doctor when they are sick, or to get preventive care like blood pressure checks.

"Without insurance coverage, people don't get the care they need when they are sick, and the preventive care they need to keep them from getting sick in the first place," said Sherry Glied, the lead author of the reports and chair of the Department of Health Policy and Management at Columbia University's Mailman School of Public Health. "When private employer-sponsored coverage declines, public health insurance and uncompensated care only fill part of the gap. We need expanded health insurance coverage to ensure that everyone has access to the benefits of health care."

“$45 Billion a Year Is Spent by the Public on Health Care and Health Insurance for Full-Time Workers and Family Members Not Covered by Employer Health Plans.” Commonwealth Fund Press Release 5/02/08.

Primary Subject: Health
Location(s): National

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