The Uninsured: Myths & Facts

by Howard Bell Printed in The New Physician magazine September 2000 issue

MYTH:	Most uninsured are poor, unemployed minorities.
FACT:	Most uninsured Americans are employed and Caucasian. Seventy-five percent live in families where at least one person works full time. Twenty percent live in families that have two full-time workers.

MYTH:	Young women are at the greatest risk for being uninsured.
FACT:	Young men are at the greatest risk. Low-income women are more likely to qualify for Medicaid, which covers pregnant women and heads of single-parent families-usually women.

MYTH:	Medicaid covers all poor people.
FACT:	Only 41 percent of the poor are covered by Medicaid, which does not cover 26 percent of poor children, 40 percent of poor women and 50 percent of poor men.

MYTH:

Poor children are more likely to be uninsured than adults.

FACT:

Children are less likely to be uninsured than adults. Medicaid has less restrictive criteria for children than it does for adults. Medicaid only covers adults who are disabled, pregnant, elderly or who take care of dependent children. The federal Children's Health Insurance Program covers children above Medicaid income eligibility limits but cuts off for those in families earning more than 200 percent of the federal poverty level.

MYTH:	Most uninsured children live in families where no one works.
FACT:	Seventy-five percent live in families where at least one family member works full time.

MYTH:	Most uninsured children live in single-parent households.
FACT:	More than half live with both their parents.

MYTH:	Poor people who work and don't get insurance through their employer can still qualify for Medicaid.
FACT:	A parent working full time at minimum wage does not qualify for Medicaid in 32 states.

MYTH:	People who don't have health insurance simply don't want to pay for it.
FACT:	Seventy-five percent of uninsured adults say the main reason they are not insured is because they cannot afford the premiums. The uninsured are more than twice as likely to live in households having difficulty paying rent, food and utility bills. For most uninsured, going without insurance is not a preference, but a result of family budget choices.

MYTH:

Poor people can use the emergency room if they need health care.

FACT:

Many poor uninsured use hospital emergency rooms as their primary source of health care, at great expense to hospitals, which pass the costs on to other patients. Emergency rooms do not provide preventive care. They do not provide dialysis, chemotherapy, medications and other services people with serious illnesses need. Out of pride or fear of debt, many low-income sick people simply do nothing about their condition.

MYTH:	People without insurance have adequate access to health care.
FACT:	Numerous studies confirm that not having health insurance reduces your access to preventive, primary and specialty care. People without insurance are more likely to live sicker and die younger.

MYTH:

Community hospitals and many doctors take care of everyone regardless of ability to pay.

FACT:

Community hospitals and many doctors do provide some charity care; however, 15 percent of uninsured pregnant women are refused prenatal care when looking for a provider. Uninsured pregnant women are more than twice as likely not to receive the standard number of prenatal checkups before delivery. Uninsured hospital patients are 29 percent less likely to undergo coronary artery bypass surgery and 45 percent less likely to undergo a hip replacement.

MYTH:	People who don't participate in employer-sponsored insurance just don't want to pay the premiums.
FACT:	Seventy-five percent of low-wage workers who are offered health benefits choose to participate. Most of those who don't say they can't afford the premiums.

MYTH:	Middle-class workers were hit just as hard as the working poor with declines in employer-sponsored coverage.
FACT:	Employer-sponsored coverage has declined more for the working poor than middle-class workers. From 1987 to 1996, coverage for the lowest-paid fell from 54 percent to 42 percent. At the same time, coverage for the highest-paid increased from 87 percent to 90 percent.