A new study released Tuesday by the Employment Policies Institute (EPI) questions the widely used estimate of 47 million uninsured Americans.
June O’Neill, co-author of the study and former Congressional Budget Office (CBO) director and Member of the President’s Council of Economic Advisors, says that more than 43 percent, or 18 million, of uninsured Americans ages 18-64, could likely afford health coverage and are actually "voluntarily uninsured."
"Current policy proposals dramatically overestimate the cost of providing affordable health insurance for those Americans who currently cannot afford coverage due to a lack of understanding of who the involuntarily uninsured population is, why they lack coverage, and the amount of healthcare resources that they currently access," O'Neill said.
She urged policymakers not to rush the healthcare debate. "This study shows that we need to better understand American’s uninsured population and the factors affecting both coverage and access to care," O’Neill said. "This new information about the current uninsured population will increase policymakers’ power to target those truly ‘at risk,’ provide the best coverage and healthcare access options for each population and decrease the cost of covering the uninsured."
O'Neill and co-author David O'Neill of City University of New York used data from a number of surveys to determine what percentage of uninsured Americans are actually unable to afford coverage. The study found that at least 43 percent of Americans in the 18-64 year-old age group have incomes at least 2.5 times the poverty level.
The study found that 79 percent of people with incomes between 2.5 and 3.75 times the poverty level currently purchase private health insurance. In view of the large percentages covered at this level, the authors consider this uninsured group as having enough disposable income to purchase health insurance.
The researchers found that the lower health status of the involuntarily uninsured could be attributed to their level of education, income, and even lifestyle habits, such as smoking and obesity, more than the mere fact that they do not carry health insurance."
The uninsured population also varies dramatically from state to state. For example, thirty percent of Texas residents are uninsured, compared to 18 percent of New York and 13 percent of D.C. residents. Three states (Texas, Florida and California) make up a third of the uninsured population, the researchers said.
"Instead of focusing on a one-size fits all approach to healthcare coverage, we should look at what individual states are currently offering and provide additional federal support as needed," according to June O’Neill.