The New Health Insurance Numbers: Whither the Public – Private Coverage Mix?

In August 2004, the U.S. Census released its most recent figures, showing that the number of Americans without health insurance increased to 45.0 million in 2003, up from 43.6 million people in 2002. Those covered by government health insurance programs increased between 2002 and 2003 — from 73.6 million to 76.8 million, largely as a result of greater coverage by Medicaid. At the same time, employer-based coverage shrank. The number of people covered by employment-based insurance fell from 175.3 million to 174.0 million from 2002 to 2003, and the share of the population covered declined from 61.3 percent to 60.4 percent.

What were the key coverage trends in 2003? Are the Census Bureau’s numbers — which differ from those generated by other government agencies — the most accurate? Why did employer coverage shrink, and what can be done about it to stem the tide? With state budget deficits easing, can Medicaid continue to pick up the slack from private coverage declines?

To help address these and related questions, the Alliance for Health Reform and The Robert Wood Johnson Foundation sponsored a September 10, 2004 briefing. Panelists were: Charles Nelson of the U.S. Census Bureau, Genevieve Kenney of the Urban Institute’s Health Policy Center and Tracy Watts of Mercer Human Resource Consulting. Linda Bilheimer of the Robert Wood Johnson Foundation provided opening remarks and the Alliance’s Ed Howard moderated.