Insurance—Those With and Those Without - Who Was Uninsured In 2002 And 2003?, Sources Of Health Insurance, Children, Health Insurance Portability And Accountability Act Of 1996

In 1798 Congress established the U.S. Marine Hospital Services for seamen. It was the first time an employer offered health insurance in the United States. Payments for hospital services were deducted from the sailors' salaries.

In the twenty-first century, many factors affect the availability of health insurance, including employment, income, personal health status, and age. As a result, an individual's or family's health insurance status often changes as circumstances change. In 2002 nearly seven of every ten Americans (69.6%) were covered during all or some part of the year by private insurance, mostly through their employers (61.3%). Medicare, the government's health insurance program for older adults and persons with disabilities, covered 13.4% of Americans, and Medicaid, the government health insurance program for the poor, covered 11.6%. (See Figure 6.1.) (Note that percentages come close to 100% because some persons are covered by more than one type of insurance program, yet in 2002 15.2% of people were not covered by any type of insurance.)

In 2002 the 15.2% of the American population without health coverage constituted a slight increase from the 14.6% uninsured in 2001, but a decrease from the 16.3% uninsured in 1998. (See Table 6.1.) The year 1998 was the first year since 1987 that the share of the population without health insurance declined. In the eleven-year period from 1987 (the first year comparable health statistics were available) to 1998, the uninsured rate either increased or remained unchanged from one year to the next. The number of uninsured children dropped in 2000, from 12.6% in 1999 to 11.6% (Robert J. Mills, "Health Insurance Coverage in the United States: 2000," in Current Population Reports, U.S. Census Bureau, September 2001).

According to the Centers for Disease Control and Prevention (CDC), 2003 marked the second consecutive yearly rise in the number of American adults without health insurance coverage. The percentage of uninsured adults rose to 20.1%, up from 19.1% in 2002. The proportion of uninsured adults in 2003 was 6.3% higher than in 1997, the peak of the U.S. economic boom and the first year for which these data were made available. Fewer children were uninsured—the percentage of uninsured children fell to 10.1% in 2003 compared to 13.9% in 1997. (See Figure 6.2.)