Insurance Coverage: 2001
Health Insurance Coverage: 2001
Reversing two years of falling uninsured rates, the share of the
population without health insurance rose in 2001. An estimated
14.6 percent of the population or 41.2 million people were
without health insurance coverage during the entire year in 2001,
up from 14.2 percent in 2000, an increase of 1.4 million people.
The estimates in this report are based on the 2002 Curren
Population Survey (CPS) Annual Demographic Supplement, conducted
by the U.S. Census Bureau. Respondents provide answers to the
best of their ability, but as with all surveys, the estimates may
differ from the actual values. A copy of the CPS Supplement
questionnaire is available electronically at http://www.census.gov/apsd/techdoc/
New Population Controls and Expanded Sample
The estimates in this report are based on the 2000, 2001, and 2002
Current Population Survey Annual Demographic Supplements (CPS ADS)
and provide information for calendar years 1999, 2000, and 2001,
respectively. These estimates use population estimates based on
Census 2000. Earlier reports presenting data for calendar years
1993 through 2000 used population estimates based on the 1990 census.
In 2001, the Census Bureau tested a sample expansion of 28,000
households to the CPS ADS. The sample expansion was officially
implemented in the estimates presented here. It is primarily designed
to improve the reliability of state estimates of children's health
insurance coverage, but the larger sample size also improves the
reliability of national estimates of other topics.
Because results presented in this report from the 2001 survey have
been recalculated based on the expanded sample and the Census
2000-based weights, they may differ slightly from earlier estimates
that did not incorporate the sample expansion and were based on the
1990 census. Appendix B presents more detail on the introduction of
the sample expansion and new population controls based on Census 2000.
All statements in this report have undergone statistical testing, and
all comparisons are significant at the 90 percent confidence level.
The number and percentage of people covered by employment-
based health insurance dropped in 2001, from 63.6 percent to
62.6 percent, the foundation of the overall decrease in
health insurance coverage.
The number and percentage of people covered by government
health insurance programs rose in 2001, from 24.7 percent to
25.3 percent, largely from an increase in the number and
percentage of people covered by medicaid (from 10.6 percent
to 11.2 percent).
The proportion of uninsured children did not change,
remaining at 8.5 million in 2001, or 11.7 percent of all
Although medicaid insured 13.3 million poor people, 10.1
million poor people still had no health insurance in 2001,
representing 30.7 percent of the poor, unchanged from 2000.
Hispanics (66.8 percent) were less likely than non-Hispanic
Whites (90.0 percent) to be covered by health insurance. /2
The coverage rate for Blacks in 2001 (81.0 percent) did not
differ from the coverage rate for Asians and Pacific
Islanders (81.8 percent).
American Indians and Alaska Natives were less likely to have
health insurance than other racial groups, based on 3-year
averages (1999-2001) - 72.9 percent, compared with 80.8
percent of Blacks, 81.5 percent of Asians and Pacific
Islanders, and 90.2 percent of non-Hispanic Whites.
However, American Indians and Alaska Natives were more
likely to have insurance than were Hispanics (67.0 percent)
Among the entire population 18 to 64 years old, workers
(both full- and part-time) were more likely to have health
insurance (83.0 percent) than nonworkers (75.3 percent), but
among the poor, workers were less likely to be covered (51.3
percent) than nonworkers (63.2 percent).
Compared with 2000, the proportion who had employment-based
policies in their own name fell for workers employed by
firms with fewer than 25 employees, but was unchanged for
those employed by larger firms.
Young adults (18 to 24 years old) were less likely than
other age groups to have health insurance coverage -- 71.9
percent in 2001, compared with 83.3 percent of those 25 to
64 and, reflecting widespread medicare coverage, 99.2
percent of those 65 years and over.
More people did not have health insurance in 2001.
The number of people without health insurance coverage rose to
41.2 million (14.6 percent of the population) in 2001, up 1.4
million from the previous year, when 14.2 percent of the
population lacked coverage (see Table 1). Interestingly, the
number of people covered by health insurance also increased in
2001, up 1.2 million to 240.9 million (85.4 percent of the
population). Both increases can be attributed in part to an
overall population growth from 2000 to 2001.
Most people (64.1 percent) were covered by a health insurance
plan related to employment for some or all of 2000, an increase
of 0.6 percentage points over the previous year. The increase in
private health insurance coverage largely reflects the increase
in employment-based insurance, which increased 0.3 percentage
points to 72.4 percent in 2000.
A decline in employment-based insurance prompted the decrease in
insurance coverage rates. /3
Most people (62.6 percent) were covered by a health insurance
plan related to employment for some or all of 2001, a decrease of
1.0 percentage point from the previous year. The 1.1 percentage
point decline in private health insurance coverage, to 70.9
percent in 2001, largely reflects the decrease in employment-
Although it did not offset the overall decline, health insurance
coverage provided by the government increased between 2000 and
2001. This increase largely reflects the increase in medicaid
coverage, which rose by 0.6 percentage points to 11.2 percent in
2001. /4 Among the entire population, 25.3 percent had government
insurance, including medicare (13.5 percent), medicaid (11.2
percent), and military health care (3.4 percent). Many people
carried coverage from more than one plan during the year; for
example, 7.6 percent of people were covered by both private
health insurance and medicare.
The uninsured rates for the poor and the near poor did not change
between 2000 and 2001.
Despite the medicaid program, 10.1 million poor people, or 30.7
percent of the poor, had no health insurance of any kind during
2001. This percentage -- more than double the rate for the total
population -- did not change significantly from the previous
year. The uninsured poor comprised 24.5 percent of all uninsured
people (see Table 2).
Medicaid was the most widespread type of health insurance among
the poor, with 40.5 percent (13.3 million) of those in poverty
covered by medicaid for some or all of 2001. This percentage did
not change from the previous year. /5
Among the near poor (those with a family income greater than or
equal to, but less than 125 percent of, the poverty level), 26.5
percent (3.3 million people) lacked health insurance in 2001,
unchanged from 2000. Although private health insurance coverage
among the near poor declined in 2001 -- from 40.3 percent to 37.8
percent -- their rate of government health insurance coverage did
not change from 2000 (it was 47.1 percent in 2001).
Key demographic factors affect health insurance coverage.
Age - People 18 to 24 years old were less likely than other age
groups to have health insurance coverage, with 71.9 percent
covered for some or all of 2001. Because of medicare, almost all
people 65 years and over (99.2 percent) had health insurance in
2001. For other age groups, health insurance coverage ranged
from 76.6 percent to 88.3 percent.
Among the poor, people 18 to 64 years old had a markedly lower
health insurance coverage rate (57.7 percent) in 2001 than either
people under 18 (78.7 percent) or 65 years and over (97.3
Race and Hispanic origin - While the uninsured rate rose in 2001
for non-Hispanic Whites - from 9.6 percent to 10.0 percent -
the uninsured rates among Blacks (19.0 percent) and among Asian
and Pacific Islanders (18.2 percent) did not change from 2000. /7
The uninsured rate among Hispanics (33.2 percent in 2001) also
did not change from 2000 (see Table 1). /8
The CPS Annual Demographic Supplement, the source of these data,
obtained interviews from 78,000 households nationwide but is not
large enough to produce reliable annual estimates for American
Indians and Alaska Natives. However, Table 3 displays 3-year
averages of the number of American Indians and Alaska Natives,
their uninsured rate, and 3-year-average uninsured rates for other
race groups. The 3-year average (1999-2001) shows that 27.1
percent of American Indians and Alaska Natives were without
coverage, higher than the 19.2 percent for Blacks, 18.5 percent
for Asians and Pacific Islanders, and 9.8 percent for non-Hispanic
Whites. /9 However, the 3-year-average uninsured rate for Hispanics
(33.0 percent) was higher than the uninsured rate for American
Indians and Alaska Natives.
Comparisons of 2-year moving averages (1999-2000 and 2000-2001)
show that while the uninsured rate fell for American Indians and
Alaska Natives from 27.7 percent to 25.5 percent and for Blacks
from 19.3 percent to 18.9 percent, uninsured rates among non-
Hispanic Whites, Asian and Pacific Islanders, and Hispanics did
Nativity - In 2001, the proportion of the foreign-born population
without health insurance (33.4 percent) was more than double that
of the native population (12.2 percent). /10 Among the foreign
born, noncitizens were much more likely than naturalized citizens
to lack coverage -- 42.9 percent compared with 17.2 percent.
Educational attainment - Among all adults, the likelihood of
being insured increased as the level of education rose. Compared
with the previous year, coverage rates decreased for those with
no high school diploma, those who are high school graduates only,
and those with some college education but no degree. Coverage
rates did not change from 2000 to 2001 for adults with an
associate degree or higher.
Economic status affects health insurance coverage.
Income - The likelihood of being covered by health insurance
rises with income. Among households with annual incomes of less
than $25,000, the percentage with health insurance was 76.7
percent; the level rises to 92.3 percent for those with incomes
of $75,000 or more. Compared with the previous year, coverage
rates decreased at every level of household income.
Work experience - Of those 18 to 64 years old in 2001, full-time
workers were more likely to be covered by health insurance (84.0
percent) than part-time workers (78.0 percent), and part-time
workers were more likely to be insured than nonworkers (75.3
percent). /11 However, among the poor, nonworkers (63.2 percent)
were more likely to be insured than part-time workers (54.0
percent), who were more likely to be insured than full-time
workers (49.7 percent).
Firm size - Of the 142.6 million workers in the United States who
were 18-64 years old, 56.3 percent had employment-based health
insurance policies in their own name. The proportion increased
with the size of the employing firm from 31.3 percent for firms
with fewer than 25 employees to 69.6 percent for firms with 1000
or more employees. (These estimates do not reflect the fact that
some workers were covered by another family member's employment-
based policy). Compared with the previous year, the proportion
who had employment-based policies in their own name decreased for
workers employed by firms with fewer than 25 employees, but were
unchanged for those employed by larger firms.
The uninsured rate for children did not change between 2000 and
The percentage of children (people under 18 years old) without
health insurance did not change in 2001 (see Table 1), remaining
at 8.5 million or 11.7 percent. A decline in employment-based
health insurance coverage of children was offset by an increase
in coverage by medicaid or the State Children's Health Insurance
Among poor children, 21.3 percent (2.5 million children) had no
health insurance during 2001, unchanged from the previous year
(see Table 2). For this group, employment-based coverage
decreased from 20.1 percent to 18.6 percent, while government
health insurance coverage increased from 60.9 percent to 63.3
percent. Poor children made up 29.3 percent of all uninsured
children in 2001.
Among near-poor children (those in families whose income was
greater than or equal to, but less than 125 percent of, the
poverty level), 21.6 percent (0.9 million children) were without
health insurance in 2001, unchanged from 2000. /12 For this group,
private health insurance coverage decreased from 39.8 percent to
36.4 percent, but government health insurance coverage did not
The likelihood of health insurance coverage varies among
Children 12 to 17 years old were more likely to be uninsured
than those under 12 -- 13.1 percent compared with 11.0
The uninsured rate declined in 2001 for Hispanic children --
from 25.3 percent to 24.1 percent. The uninsured rates for
non-Hispanic White children (7.4 percent), Black children
(13.9 percent), and Asian and Pacific Islander children
(11.7 percent) were unchanged from 2000.
While most children (68.4 percent) were covered by an
employment-based or privately purchased health insurance
plan in 2001, nearly one in four (22.7 percent) was covered
Black children had a higher rate of medicaid coverage in
2001 than children of any other racial or ethnic group -
38.3 percent, compared with 34.9 percent of Hispanic
children, 18.0 percent of Asian and Pacific Islander
children, and 15.3 percent of non-Hispanic White children.
Children living in single-parent families in 2001 were less
likely to be insured than children living in married-couple
families - 84.3 percent compared with 90.4 percent.
Some states had higher uninsured rates than others.
The proportion of people without health insurance ranged from 7.2
percent in Rhode Island to 23.2 percent in New Mexico, based on
3-year averages for 1999, 2000 and 2001 (see Table 4). Although
the data presented suggest that New Mexico had the highest
uninsured rate, its rate was not statistically different from the
rate for Texas. Similarly, although the data suggest that Rhode
Island had the lowest uninsured rate, its rate was not
statistically different from the rate for Minnesota.
Comparisons of 2-year moving averages (1999-2000 and 2000-2001)
show that the proportion of people without coverage fell in 14
states: Alaska, Arizona, Idaho, Louisiana, Massachusetts,
Montana, Nevada, New Mexico, North Dakota, South Carolina, South
Dakota, Virginia, West Virginia and Wisconsin. Meanwhile, the
proportion of people without coverage rose in nine states:
Arkansas, Georgia, Indiana, Missouri, Ohio, Oklahoma,
Pennsylvania, Rhode Island, and Texas.
Accuracy of the Estimates
Statistics from surveys are subject to sampling and nonsampling