By
New figures from the U.S. Census Bureau show that 16% of the 45 million U.S. residents who lacked health coverage in 2003 had annual household incomes over $75,000 per year.
The number of high-income uninsured U.S. residents grew 4.5% between 2002 and 2003, to 7.6 million. That compares with an increase of 3%, to 37.4 million, in the number of uninsured with annual household incomes under $75,000.
The census results could help health insurance company and agent groups defend proposals to offer different solutions for low-income, moderate-income and high-income uninsured people, rather than setting up a single, government-run program for all uninsured U.S. residents.
But Hanns Kuttner, a senior economist at the Economic Research Institute on the Uninsured, Ann Arbor, Mich., warns against assuming that the census figures prove the existence of a big, untapped market for private individual health coverage.
"Whats unknown is how long people are without health insurance," Kuttner says.
Anecdotal evidence and some surveys suggest that many high-income uninsured people are people who are moving quickly from one group health plan to another, Kuttner says.
The federal government and state governments have worked hard in recent years to expand coverage for some low-income U.S. residents, such as children.
Although the percentage of U.S. residents with individual or employer-sponsored health coverage fell to 68.6% in 2003, from 69.6% in 2002, expansion of government insurance programs held down the increase in the overall uninsured rate, which rose to 15.6% in 2003, up from 15.2% a year earlier.
Experts point out that high-income residents may have many reasons for lacking health coverage.
One reason is that some "high-income" U.S. residents feel as if they are just getting by. An annual income of $75,000 may not go very far for a family living in New York, San Francisco or other communities with high costs of living.
Other high-income people may do without health coverage because they are "between jobs," are too sick to qualify for coverage, or belong to religions that discourage the use of conventional health care.
From an economists point of view, in many cases, "the people at this income level who didnt buy health insurance have a lower taste for health insurance" than lower income people without health coverage, Kuttner says.