"The Big Picture" Newsletter

October 2008 Issue

Access to Quality and Affordable Health Care for Every American

Latest U.S. Census Bureau estimates report a decline in the number of uninsured

The national elections are now just weeks away and access to affordable, quality health care remains near the top of the list of policy concerns for the presidential candidates and the public. We’ve heard estimates of the number of uninsured Americans, and ideas offered by both candidates to reduce that number. Proposals for real health care reform won’t work unless they provide a means to increase access, contain costs and improve the quality of care.

One important set of facts fundamental to the discussion comes from the U.S. Census Bureau, which previously counted some 47 million Americans without health insurance. The Bureau recently updated its estimate and reported a modest decline in the number of uninsured for 2007. The Report offers some intriguing details and insights with respect to this issue:

• The number of people with health insurance increased to 253.4 million, an increase of 3.6 million. While private health insurance coverage grew for the first time since 1999 (up 300,000) it was the growth in the government-funded programs of Medicare and Medicaid that accounted for more than three-fourths of the growth in coverage in 2007.
• In 2007, more than 177 million Americans received health insurance through the workplace. In fact, employer-based coverage accounted for 70% of the overall health insurance market. Despite speculation that the employer-based system is in decline, the percentage of employees receiving health insurance from an employer has remained relatively unchanged over the last two decades.
• The percentage and number of people without health coverage decreased in 2007. The percent of Americans without health insurance declined from 15.8% to 15.3% between 2006 and 2007, and the number of uninsured declined by 1.3 million to 45.7 million.
• The number of children under 18 without health insurance declined from 8.7 million to 8.1 million. Nearly a million more children were added to the Medicaid and SCHIP (State Children’s Health Insurance Program) rolls in 2007.
• The uninsured population is not homogeneous. Nearly 60% of the uninsured are below the age of 34 and 18% are under 18. About 17.6 million of the uninsured had incomes higher than $50,000 and 58% worked sometime during the previous year. In addition, some 9.7 million were not US citizens; and 44% of all non-citizens had no health coverage.

After all the votes are counted in November, the real work of providing access to affordable health care coverage will begin in earnest. Policy makers would be well-advised to acknowledge that no single policy or program will address the various circumstances and needs of this clearly diverse uninsured population.

CIGNA believes that every American should have access to high-quality coverage at an affordable cost. It will take a concerted effort by our leaders in Washington and in state capitals across the country – working side by side with the private sector – to meet this challenge. Neither government nor industry can do it alone.

CIGNA's approach to making health care more accessible and more affordable is to build upon what already works – the employer-based system. We believe that expansion of the employer-based system, which covers most Americans today, coupled with comprehensive efforts to improve quality and contain costs, is a path we can take to solve the problem of the uninsured.

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