WASHINGTON -- The number of Americans without health insurance declined last year for the first time since the Census Bureau began collecting data in 1987. Health care advocates and analysts cited the robust economy as the main reason.
About 42.5 million people, or 15.5 percent of the population, lacked insurance in 1999, compared with 44.2 million, or 16.3 percent, in 1998, according to data released Thursday.
The percentage of people in 1999 by state and the District of Columbia without health insurance coverage for the entire year, according to the Census Bureau.
The number of uninsured children fell by 1.5 percentage points to 13.9 million, according to the Census Bureau's annual report on health insurance coverage in America.
Analysts attributed the overall drop, in large part, to two factors: more employers offering health coverage as a way to lure or keep workers in a tight labor market and healthy economy, and the Child Health Insurance Program, enacted by Congress in 1997 to assist low-income families.
The report showed that 62.8 percent of Americans had coverage through an employment-related health insurance plan, compared with 62 percent in 1998. The percentage of those covered under Medicare remain constant at 13.2. There was a 0.1 percentage point decline in Medicaid coverage, to 10.2 percent in 1999.
"It's a good news-bad news situation," said Diane Rowland, executive director for the Kaiser Commission on Medicaid and the Uninsured. "There's a decline in the kinds of increases we've seen. The worst news is we still have 42 million uninsured."
Added Census Bureau analyst Robert Mills: "The driving force behind this improvement was an increase in the likelihood of people having employment-based health insurance."
Both health care reform advocates and industry supporters used the report to promote their positions on an issue that has drawn attention on Capitol Hill and the presidential campaign.
Chip Kahn, president of the Health Insurance Association of America said that the data proved that "a private, employer-based system works."
He cited figures showing that since 1993, the number of people covered under employment-based policies increased from 148 million to 172 million.
"It's a function of more jobs being created and a tight labor market which is encouraging more employers to offer more coverage," said Kahn, placing the onus on Congress "to reduce that number by tens of millions."
The report was not entirely encouraging, said Ron Pollack, executive director of the Washington-based consumer group, Families USA.
For instance, he said, 32.4 percent of people living below the poverty line remained uninsured, along with 47.5 percent of low-income, full-time workers.
"Many people lost health coverage when the moved from welfare into entry-level jobs that have no health benefits," Pollack said. "The most sobering part ... there still very high numbers come at a time when the economy is doing very well."
Among the states, 25.6 percent of the residents in New Mexico were uninsured in 1999, the highest in the country. Texas ranked next-to-last, with 23.3 percent; in 1998, it was 50th at 24.5 percent.
Rhode Island had the smallest percentage of uninsured in 1999, 6.9 percent, followed by Minnesota at 8 percent.
Texas Gov. George W. Bush, the Republican presidential nominee, has proposed a number of health insurance initiatives, including a tax credit of up to $2,000 per family to help low-income working Americans buy health insurance.
Democratic candidate Al Gore has proposed expanding the federal-state health plan for children to enroll more children and allow parents to join.
Among the report's other findings:
-- More Hispanics (33.4 percent) were likely to be uninsured than any other of the major racial or ethnic group. Still, the percentage fell from 35.3 in 1998.
-- Adults age 18 to 24 remained the least likely to be uninsured (29 percent), but the figure was 30 percent in 1998.
-- The percentage of uninsured foreign-born residents declined from 34.1 percent to 33.4 percent. The percentage for U.S.-born residents fell nine-tenths of a percentage point, to 13.5 percent.
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