Research by Author & Topic

Publications by Stephen Zuckerman on Health Statistics

This study, funded by the Maine Health Access Foundation, presented alternative estimates of the costs of health care that uninsured Maine residents receive and determined how much public revenue was available to offset those costs. Using data from health care providers, the study estimated that the costs of caring for the uninsured in Maine were $138 million in 2005, with hospitals and Veterans' Affairs facilities identified as the largest providers. Estimates based on household survey data from the Medical Expenditure Panel Survey showed that uncompensated care costs for the uninsured were only $81 million in 2005. The report discusses possible reasons for the large discrepancy between these two sources. Our review of federal and state funding sources in 2005 suggests there were roughly $110 million available to offset these costs of caring for the uninsured.

The Maine Health Care Access Foundation funded this profile of Maine health insurance coverage. According to data from the Current Population Survey, 124,000 Maine residents did not have health insurance during the 2004–2005 period. The majority (84%) of uninsured people were adults. Just over half of Maine residents who were uninsured came from low-income families residents. Low-income young adults (ages 19–34) were particularly at risk for being uninsured, and one-quarter lacked coverage. Over 86,000 of Maine's uninsured people were workers. Forty-seven percent of this uninsured group were low-income, over half (55%) were employed by firms with fewer than 25 workers, and just over two-thirds worked in industries with low rates of job-based health coverage. Over two-thirds (67%) of Maine's uninsured people came from families with one or more full-time worker, while another 19 percent are from families with a part-time worker.

This paper uses data from the 1999 and 2002 rounds of National Survey of Americas' Families to examine variation and trends in the duration of uninsurance. The results show that 49 million people were uninsured at some time during the 2001-2002 period, with over half (26 million) being uninsured for 12 months or longer. Rates of short-term uninsurance for various subgroups were often similar, while rates of long-term uninsurance varied widely and accounted for large differences in overall uninsurance rates. Although a slightly smaller share of the population was uninsured for 12 months or more in 2002 than in 1999, the overall change in the rate of uninsurance was small.

Data from the 2002 National Survey of America's Families shows that 17 percent of adults were without health insurance in 2002--similar to the rate in 1999. The number of adults without health insurance rose by 2.0 million to 29.1 million in 2002. Employer-sponsored coverage of adults fell from 72.2 to 70.5 percent while public coverage of adults increased from 4.7 to 5.7 percent. Uninsurance for Hispanics and poor adults increased by 3 percent. Uninsurance for blacks decreased by 3 percent and was unchanged for whites.

Using data from the 1997 National Survey of America's Families and county-level data on local safety net conditions, the authors find little variation in utilization and access among low-income adults by local safety net conditions, but very large differences by insurance status, after controlling for individual demographic characteristics and health care market characteristics. This suggests that expanding insurance coverage would be a more effective tool for increasing health care use and access among low-income adults than expanding the safety net.