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OCR Page 1 of 17THE WHITE HOUSE
WASHINGTON
November 13, 1998
INFORMATIONAL MEMORANDUM TO THE PRESIDENT
me
FROM:
Chris Jennings and Jeanne Lambrew
THROUGH: Bruce Reed, Gene Sperling
SUBJECT:
Recent Uninsured Trends and Analyses
As you know, the Census Bureau recently estimated that 43.7 million Americans are uninsured --
an increase of 1.7 million from 1996 and nearly 5 million from 1992. Insurance coverage is one of
the few social indicators that has not improved in the last several years. This contradicts the theory
that a strong economy with low unemployment yields a high demand for workers, and thus better
benefits like health insurance. It is even more
disappointing given record-low health care cost growth in
Rate of Uninsured Among the
the last several years, which should make insurance more
Non-Bderly, 1987-1997
20%
17.3%
17.4%
18.3%
14.8%
15.7%
16.3%
affordable and thus more common. This increase has
15%
important consequences since the uninsured are four times
more likely to not receive needed health care, have
10%
hospitalization rates for preventable conditions that are 50
5%
to 75 percent higher, and place growing uncompensated
0%
1987
1989
1991
1993
1995
1997
care burdens on the nation's providers.
Sarce: EBRI, 1998
Because of the importance of this problem and your expressed interest in these data, we are
providing you an analysis of the numbers and recent insurance coverage trends, as well as a
summary of their policy implications.
Uninsured by age: Most of the uninsured in America are young; over 80 percent are under age 45
(35.2 million). These uninsured are disproportionately ages 18 to 24 -- 30 percent of whom are
uninsured compared to 15 percent of children. The number of uninsured children did not increase in
1997, remaining at 10.7 million. This contrasts dramatically with last year's data that showed that
800,000 of the 1.1 million additional people who were uninsured were children. The change
appears to be the result of the unprecedented focus on
Rate of Uninsured by Age, 1997
children's health in 1997. Beginning with the State of the
30%
Union and ending with the establishment of your Children's
30%
23%
Health Insurance Program (CHIP), the Federal Government
17%
20%
15%
14%
14%
and the states started taking actions to address this serious
problem. Next year, after Census' data reflects a full year's
10%
<1%
operation of CHIP, we would expect the number of
0%
uninsured children to fall.
<18
18-24
25-34
35-44
45-54
55-64
65+
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