oversight

Health Insurance: A Profile of the Uninsured in Michigan and the United States

Published by the Government Accountability Office on 1990-05-31.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

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                                          c
             United States
GAO          General Accounting Office
             Washington, DC 20548

             Human Resources         Division

             B-23925 1

             May 341990

             The Honorable Donald W. Riegle, Jr.
             Chairman, Subcommittee on Health for
               Families and the Uninsured
             Committee on Finance
             United States Senate

             Dear Mr. Chairman:

             This report responds to your request and subsequent discussions with
             your Subcommittee staff for information on the characteristics of indi-
             viduals without health insurance in Michigan and the United States. In
             response to your request, we developed data on income, employment,
             age, marital status, and other characteristics of uninsured individuals
             using Bureau of the Census Current Population Survey data for 1987,
             the latest year data were available when we began our work. (See app. I
             for details on the survey.)


             Over 30 million Americans are not covered by health insurance, one of
Background   the most important strands in the social safety net. Estimates of unin-
             sured populations suggest that considerable gaps remain in the health
             insurance coverage of our nation’s citizens despite the almost lOO-
             percent coverage of the elderly through Medicare, the expansions in
             Medicaid coverage, and an increase in protection provided through
             employer/union-sponsored health plans.

             Although the primary means of getting private health insurance is
             through employment, most of the uninsured are employed. This lack of
             health insurance has prompted intense scrutiny in the Congress, mani-
             fested most recently by the Pepper Commission’s recommendations for
             universal insurance coverage.’




             ‘On March 2, 1990, the U.S. Bipartisan Commission on Comprehensive Health Care, formerly the
             Pepper Commission, released its recommendations to the Congress on “Access to Health Care and
             Long-Term Care for All Americans.”



             Page 1                                   GAO/HRD-90-97 Uninsured in Michigan and in the U.S.
                            I%229251




                            In 1987, more than 35 million persons (under age 65)” in the United
Results in Brief            States did not have some form of health insurance coverage.3 More than
                            860,000 of these uninsured individuals were Michigan residents. The
                            numbers of uninsured in Michigan have fallen below the peak level
                            experienced in 1984 when more than 1 million persons were without
                            health insurance. Nevertheless, the uninsured population is still one of
                            the more prominent public health issues in Michigan and the nation.

                            Michigan’s uninsured population has many of the same characteristics
                            as those embodied in the national uninsured population. A high percent-
                            age of uninsured people were among the lower income, minority, youth,
                            and unmarried segments of the population. Most uninsured people in
                            Michigan live in families with an employed worker. Mirroring national
                            patterns, more than 30 percent of the uninsured worked full time or full
                            year, but a higher percent of uninsured (more than 40 percent) was
                            among part-time/part-year workers. Also, the uninsured rate for work-
                            ers in the service industries was 10 percent in 1987. As the part-time-
                            worker population and employment in the service industries grow and
                            become a more important component of a more diversified Michigan
                            economy, solutions to the problem of the working uninsured become
                            more important.



GAO’s Analysis

Michigan Had 10.8 Percent   The probability of being uninsured varies depending on where people
Uninsured in 1987           live. Even though Michigan’s IO&percent uninsured rate was among the
                            lowest (43rd) of the 50 states and the District of Columbia, there still
                            were more than 860,000 uninsured persons in the state. Uninsured rates
                            among the states ranged from about 8 percent in Minnesota to more than
                            28 percent in New Mexico. The higher rates tend to cluster in the South
                            Central section of the United States. The percentages of uninsured per-
                            sons by state are shown in figure 1.


                            ‘As the majority, about 99 percent, of individuals 66 and older had Medicare or private insurance,
                            this age group was not included in our study.

                            3Estimates of the number of uninsured persons in I987 range from 31 to 35 million The lower figure,
                            31 million, is a revised estimate based on analysis by others, of questions added to the March 1988
                            Current Population Survey. The questions centered around health insurance coverage of children
                            through private insurance provided by sources outside the household or by Medicaid. The revised
                            estimate primarily affects analyses of uninsured that include children and has no effect on rates of
                            insurance by income and employment presented in this report.



                            Page 2                                     GAO/HRD90-97 Uninsured in Michigan and in the U.S.
                                           B-239261




Fiaure 1: Uninsured by Percent of State Populations (1987)




                                                      Below 10 percent
                                              t
                                              wj      From 10 thru 14 percent

                                                      From 15 thru 19 percent

                                                      From 20 thru 24 percent (includes the District of Columbia)

                                                      From 25 thru 29 percent




                                            Among the nine geographic regions in the United States, uninsured rates
                                            ranged from about 10 percent in New England to about 25 percent in the
                                            West South Central region. The East North Central region, of which
                                            Michigan is a part, had the third lowest percentage (12.6 percent) of



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                                                                                                                             -
                          B239261




                          uninsured when compared with the other eight regions (see app. II for
                          uninsured rates by regions and states).


Proportion of Uninsured   The percentage of people with health insurance coverage in Michigan
Declines in Michigan      was greater than the national percentage. In 1987, about 84 percent of
                          the nation’s population under age 65 had some form of health insurance
                          coverage. In Michigan, 89 percent of the population was covered,
                          exceeding the national rate by 5.6 percentage points. The recent trend
                          shows that the portion of Michigan’s population not covered by health
                          insurance began to decline in the mid 1980s. From 1984 to 1986, the
                          level of uninsured declined from 13.3 to 11.9 percent in Michigan, while
                          the national rate was more stable, edging down from 17.8 to 17.6 per-
                          cent (see fig. 2). There were further reductions in the uninsured rate
                          from 1986 to 1987, for both Michigan and the nation (the 1987 rates
                          were 10.8 and 16.5 percent, respectively), but these changes reflect,, in
                          part, a change in the way the Current Population Survey measured the
                          uninsured, making it difficult to assess whether the change in 1987
                          reflects any real improvement in the level of health insurance coverage.4




                          41naddition to added questions on children’s health insurance coverage, the March 1988 Current
                          Population Survey contained changes in the way individuals were asked questions about their insur-
                          ance coverage. Because of these changes, the Bureau of the Census suggests that caution be exercised
                          in interpreting the 1987 uninsured rate changes.



                          Page 4                                     GAO/HRLMO-97 Uninsured in Michigan and in the U.S.
                                     lb239261




Figure 2: Percent of Population
Uninsured in the United States and
                                     20     Percmt    Uninsumd
Michigan (1982-87)




                                            I,       ,I United States
                                                       Michigan

                                     Note: Includes only people under age 65.

                                     Source: Bureau of the Census, Current Population Survey (Washington, DC, 1987).




Employer/Union-                      Most of the nation’s insured population obtained health insurance cover-
Sponsored Health                     age through employer- or union-sponsored health insurance plans,
                                     which increased from 1985 to 1987 (see table 1). Likewise, the majority
Insurance Coverage                   of the improvement in Michigan’s level of health insurance coverage
Increases                            since 1984 comes from an increase in employer- or union-sponsored
                                     insurance, a reflection of the pronounced improvements since 1984 in
                                     Michigan’s manufacturing sector, which has traditionally provided
                                     health insurance coverage for its workers. The federally sponsored
                                     Medicaid program coverage rate in Michigan decreased about 4 percent,
                                     resulting in a 30-percent decline in the number of persons under age 65,
                                     covered by Medicaid, whereas in the United States, Medicaid coverage
                                     increased slightly.




                                     Page   6                                   GAO/~99-97      Uninsumd   in Michigan   and in the U.S.
                                                  B-239261




Table 1: Health Insurance Coverage of Individuals Under Age 65 in the United States and Michigan (1985 and 1987)
Number     of individuals is in thousands
                                                            United States                                               Michigan
                                                      1985                 1987                                1985                          1987
Type of insurance                                    No.   Percent        No.   Percent                       No.   Percent                 No.   Percent
Private                                     --
Employer- or union-sponsored                     134,570            64      142,747               67        5,363             66         5,803                73
Individual-provided                               15,370             7       12,470                6          525              7           474                 6
Public (federal)                                                          ~~ -
Medicaid         .____                            14,250             7           14,861            7          996             12           694                 9
Medicare                                           2,510             1            2,095            1          118              2         -. 96                 1

CklJQ$$Sa,     Veterans Affaws, Military           5,820             3        5,287                3           a3               1            50                1
Subtotal                                     172,520                82     177,460                84       7,085              88         7,117                8gc
No insurance coverage ___-
~.~-~                                            36,900             ia           35,167           17        1,003             12            861               11
Total                                        209,420              100      212,628c            1ooc        8,08gc           100          7,977C              100
                                                  aThe CIvIlian Health and Medical Program of the Uniformed Services is operated by the Department of
                                                  Defense. It provides reimbursement for covered medical care rendered in clvlian faclllties to wives and
                                                  children of active military personnel, retired military personnel, and their dependents, and dependents
                                                  of deceased personnel.

                                                  bArmed Forces members and their dependents       lkvlng in off-base housing or on-base military housing,

                                                  ‘Numbers do not add to total due to rounding.




Job Growth, Uninsured                            Nearly all of the employment growth in both Michigan and the United
Workers Concentrated in                          States occurred in the service sector of the economy. However, the ser-
                                                 vice industry uninsured rates were much higher than those in other sec-
Service Sector                                   tors of the economy. While the uninsured rate was much lower in the
                                                 manufacturing sector, particularly in the durable goods industries,
                                                 employment growth was negligible. Overall, Michigan’s uninsured rates
                                                 were lower than the United States’ rates in both the manufacturing and
                                                 service sectors even though its employment growth rates were lower
                                                 (see tables 2 and 3). Nevertheless, solutions to the working uninsured
                                                 problem become more important as the service industries grow and
                                                 become a larger share of a more diversified Michigan economy.




                                                 Page 6                                       GAO/HRb9@97 Uninsured           in Michigan   and in the U.S.
                                         B239251




Table 2: Percent of Uninsured Workers
(1987) and Employment Growth in United                                                     Percent of
States, by Industry (1985-87)                                                            uninsured in                             Percent of
                                                                                           combined             Employment      employment
                                                                                   industry cate ory            (thousands)        growth or
                                         Combined industry categories                          (1%87)            1985      1987      decline
                                         Manufacturing    (durable and
                                         nondurable)                                                  10        22,300        22,166                -1
                                         Services                                                     14        70,745        74.704                     6
                                         Other                                                        20        20,133        20,184                     0
                                         Total                                                                113.179       117.054
                                         Notes:

                                         1, The data in this table are based on individuals aged 19-64 who responded to employment industry
                                         related questions.

                                         2. For a detalled breakdown   of employment categories for the United States, see appendix it1


Table 3: Percent of Uninsured Workers
(1987) and Employment Growth in                                                            Percent of
Michigan, by Industry (1985437)                                                          uninsured in                             Percent of
                                                                                           combined             Employment      employment
                                                                                   industry cate ory            (thousands)        growth or
                                         Combined industry categories                           (1887,           1985      1987      decline
                                         Manufacturing    (durable and
                                         nondurable)                                                     6       1,163         1,199                     1
                                         Services                                                     10         2.415-
                                                                                                                 ~,            -,___
                                                                                                                               2.683      -         11
                                         Other                                                        18           523           546
                                                                                                                                                    -~4
                                         Totat                                                                  4.121          4.428

                                         Note: The data in thus table are based on individuals aged 19-64, who responded to employment Indus-
                                         try-related questions.




Family Income an                         Those with low incomes are more likely to be without health insurance
Important Indicator of                   coverage. In Michigan, more than 26 percent of persons in families with
                                         incomes below the 1987 federal poverty level were uninsured. Michi-
Insurance Status                         gan’s uninsured rate among the poverty population is considerably
                                         lower than the 37-percent rate in the United States (see table 4). Total
                                         annual money earnings for the majority of uninsured workers were less
                                         than $10,000 in 1987.




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                                         B239261




Table 4: Percent Uninsured for
Individuals Under Age 65, by Income                                         United States                                 Michigan
Class (1987)                             Ratio of family            Population in                               Population in
                                         income to                  income class          Percent in           income class          Percent in
                                         poverty                      (thousands)     income class               (thousands}      income class
                                         Under 1.0                             31,180                 37                 1,088                   26
                                         1.0-I .99                             36,150                 29                 1,110                   20
                                         2.0 and over                         145,300          ~_      9                 5,779                    6
                                         Total                                212.630                 17                 7,977                   11


                                         Lack of health insurance coverage is not restricted to the low-income
                                         population. In 1987, more than one-third of all the uninsured were in
                                         families with incomes at least twice the poverty level (see table 5).
                                         About 13 percent of Michigan’s uninsured workers earned $20,000 or
                                         more in 1987 (see table 6).

Table 5: Distribution of the Uninsured
Population Under Age 65, by Income                                                        Distribution of uninsured
Level (1987)                                                                  United States                          Michigan
                                         Ratio of family                    Number         Percent of            Number       Percent of
                                         income to                        uninsured         uninsured          uninsured       uninsured
                                         poverty                       (thousands)         population       (thousands)       population
                                         Under 1.0                             11,570                 33                   285                    33
                                         1.0-l .99                             10,560                 30                   220                    26
                                         2.0-4.99                              10,680                 30                   282                   33
                                         5and over                              2,360                  7                    74                    9
                                         Total                                 35.170               100                    861                  1008
                                         %hmbers     do not add to total due to rounding.


Table 6: Income Levels of Uninsured
Workers in Michigan, Aged 19-64 (1987)                                                                  Uninsured      workers (percent)
                                                                                                    Full-time/         Part-time/
                                         Personal income                       -11
                                                                                                     full-year
                                                                                                        -..             part-year        Total
                                         u-9,999                       ---                                   15         -     -40           55
                                         10,000-19,999                                                         18               15          33
                                         20.000-29.999                                                         6                  1          7
                                         30,000-39,999                                                         2                  0          3
                                         %,OOO and over           ~-    --~                                    2                  1          3
                                         Total                                                                43                57        1008
                                         aNumbers do not add to total due to rounding




                                         Page 8                                         GAO/HRD9@97        Uninsured   in Michigan   and in the U.S.
                                         B239261




Many Employed People                     Though unemployed people had the highest uninsured rate among the
                                         different employment categories, many employed people also were with-
Are Uninsured                            out health insurance coverage. Most of the working uninsured in Michi-
                                         gan were part-time/part-year   workers” (see tables 7 and 8). But even
                                         full-time or full-year workers were not assured of health insurance cov-
                                         erage. Nearly one-third of Michigan’s uninsured workers had full-time
                                         jobs in 1987.

Table 7: Uninsured As a Percent of the
Population Aged 19-64, by Employment     Figures in percent
Status (1987)                                                                                                            Distribution
                                                                                                                 United States        Michigan
                                         Employment status                                                         uninsured        uninsured
                                         Full-time/full-year                                                                 10                  7
                                         Part-time/part-year                                                                 22                 14
                                         Unemployed                                                                          42                 41a
                                         Not in work force                                                                   18                 11
                                         %ampling error is plus or minus 13 percentage points at the 95-percent confidence level

Table 8: Distribution of Uninsured
Individuals Aged 19-64, by Employment    Figures in percent                                                                                      .-
Status (1985 and 1987)                                                                                  Distribution
                                                                                        United States                      Michigan
                                         Employment status                               1985           1987              1985               1987
                                         Full-time/full-year                                 28             35               27                32
                                         Part-time/part-year                                 44            ~42               46                41
                                         Unemployed or not in work          -
                                         force                                               28            24                27                28
                                         TotaP                                              100           100               100               100
                                         aNumbers may not add   to total due lo rounding.




Demographic                              The likelihood of being uninsured is greater among the youth, minori-
Characteristics of the                   ties, the unmarried, and those who do not have a college education com-
                                         pared with others in the same demographic category. In Michigan, the
Uninsured                                uninsured rates were high for people that were aged 19-24 (17 percent),
                                         Hispanic (22 percent), and black (17 percent), compared with about 10
                                         percent white; unmarried or separated (from 15 to 20 percent compared
                                         with 5 percent of married persons); and had no more than a grade

                                         “The Bureau of the Census’ Technical Documentation for the Current Population Survey states that
                                         part-time workers include people who worked less than 35 hours per week in a majority of the weeks
                                         worked during the year. People who worked full time for less than 50 weeks are considered part-year
                                         workers by Census.



                                         Page 9                                        GAO/HRD9@97      Uninsured   in Michigan    and in the U.S.
                                                                                                                                             -
                                      FM39261




                                      school education (about 20 percent compared with 6 percent of those
                                      completing 1 or more years of college). This pattern in Michigan was
                                      consistent with that of the nation (see tables 9 and 10 and figures 3
                                      and 4).

table 9: Percent of Population
Uninsured, by Age Group { 1987)                                                                                Uninsured (percent)
                                      Ranges of ages in years                                               United States     Michigan
                                      55-64                                                                               11                 7
                                      45-54                                                                               11                  5
                                      35-44                                                                               12                  8
                                      25-34                                                                               17                 13
                                      19-24                                                                               25                 17
                                      18andyounger                                                                        20                 12




Figure 3: Percent of Population
Uninsured, by Race or Ethnic Origin
                                -
                                      50
(1987)




                                            White                Black


                                           1        1 unitedstates
                                                     Michigan


                                      Note: Includes only people under age 65
                                      %ampling error IS plus or minus 11 percentage points at the %-percent confidence level for Hispanics
                                      In Michigan.
                                      Source: Bureau of the Census, Current Population Survey (Washington, D.C., 1987).




                                      Page10
Table 10: Uninsured Under Age 65, by
Marital Status (1987)
                                                                                                                        Uninsured
                                       Marital status                                                            United States    Michigan
                                       Married                                                                                   10                 5
                                       Widowed                                                                                   23                23”
                                       Divorced or seoarated                                                                     22                15
                                       Never married                                                                             24                20
                                       %ampling error is plus or minus 10.7 percentage points at the 95percent      confidence     level.



Figure q: Percent of Population
Uninsured, by Education Level (1987)
                                       50   Percent of population




                                       40




                                            Grade school              High school


                                            1       1 United States

                                                       Michigan

                                       Note, Includes only people under age 65.

                                       %ampling error is plus or minus 6 percentage    points at the 95percent    confidence level for the grade
                                       school group in Michigan.

                                       Source: Bureau of the Census, Current Population Survey (Washington. DC., 1967)


                                       We agreed to focus our work on identifying and comparing the charac-
Objectives, Scope, and                 teristics of uninsured people in the United States and Michigan. Addi-
Methodology                            tionally, we developed statistics on changes in the uninsured population
                                       over a recent period.




                                       Page 11                                        GAO/HRD9@97      Uninsured     in Michigan      and in the U.S.
I%239261




To determine the growth in the number of uninsured and characteristics
of uninsured individuals under age 65, we analyzed the Bureau of the
Census’ Current Population Survey data for 1982 through 1987. For
most of our analyses we used Census survey data collected for 1987.
The data collected for 1988 were not available when we began our
analysis.


We are sending copies of this report to the Secretary of Health and
Human Services and will make copies available to others on request. As
agreed with your staff, we did not obtain agency comments on this
report. If you or your staff have questions concerning this report, please
call me on (202) 275-5451. Other major contributors to this report are
listed in appendix IV.

Sincerely yours,




Mark V. Nadel
Associate Director, National
  and Public Health Issues




Page 12                        GAO/llRlM@W   Uninsured   in Michigan   and in the US.
Page 13
contents


Letter                                                                                                         1
                                   .
Appendix I                                                                                                   16
Current Population
Survey
Appendix II                                                                                                  18
Uninsured
Populations, by Region
and State (1987)
Appendix III                                                                                                 20
Uninsured Rates for
Workers (1987) and
Employment Growth
in the United States,
by Industry Group
(1985237)
Appendix IV                                                                                                  21
Major Contributors to
This Report
Tables                   Table 1: Health Insurance Coverage of Individuals Under                               6
                             Age 65 in the United States and Michigan (1985 and
                              1987)
                         Table 2: Percent of Uninsured Workers (1987) and                                      7
                             Employment Growth in United States, by Industry
                             (1985-87)
                         Table 3: Percent of Uninsured Workers (1987) and                                      7
                             Employment Growth in Michigan, by Industry
                             (1985-87)
                         Table 4: Percent Uninsured for Individuals Under Age 65,                              8
                             by Income Class ( 1987)




                         Page 14                       GAO,JHRLk99-97   Uninsured   in Michigan   and in the U.S.
          contents




          Table 5: Distribution of the Uninsured Population Under                                8
              Age 65, by Income Level (1987)
          Table 6: Income Levels of Uninsured Workers in                                         8
              Michigan, Aged 19-64 (1987)
          Table 7: Uninsured As a Percent of the Population Aged                             9
               19-64, by Employment Status (1987)
          Table 8: Distribution of Uninsured Individuals Aged                                    9
               19-64, by Employment Status (1985 and 1987)
          Table 9: Percent of Population Uninsured, by Age Group                            10
              (1987)
          Table 10: Uninsured Under Age 65, by Marital Status                               11
              (1987)

Figures   Figure 1: Uninsured by Percent of State Populations                                3
               (1987)
          Figure 2: Percent of Population Uninsured in the United                                5
               States and Michigan (1982-87)
          Figure 3: Percent of Population Uninsured, by Race or                             10
               Ethnic Origin (1987)
          Figure 4: Percent of Population Uninsured, by Education                           11
               Level (1987)




          Abbreviations

          CHAMPUS    Civihan Health and Medical Program of the Uniformed
                         Services


          Page 15                        GAO,‘HRD9&97   Unhmred   in Michigan   and in the US.
Appendix I

Current Population Survey


               The Bureau of the Census’ Current Population Survey is the source of
               official government statistics on employment and unemployment. For
               the survey, households are scientifically selected on the basis of area of
               residence to represent the nation as a whole, individual states, and other
               specified areas. The current sample consists of about 60,000 households.
               The universe is the civilian noninstitutional population of the United
               States and members of the Armed Forces living with their families in
               civilian housing units or on a military base. A probability sample is used
               in selecting housing units. Each household is interviewed once a month
               for 4 consecutive months during a l-year period, and again for the cor-
               responding time period a year later. This technique enables Census to
               obtain month-to-month and year-to-year comparisons at reasonable cost.

               The Current Population Survey also provides monthly labor force data,
               including supplemental data on work experience, income, noncash bene-
               fits, and&$&ion.     Comprehensive information is collected on the
               employment status, occupation, and industry in which individuals work.
               Additional data are available on the number of weeks and hours per
               week individuals worked and individuals’ total income. Although the
               main purpose of the survey is to collect data on the employment situa-
               tion, an important secondary purpose is to gather information on the
               demographic status of the population. This includes age, sex, race, mari-
               tal status, educational attainment, and family structure. The results
               serve to update similar information collected once every 10 years
               through the decennial census. Government policymakers and legislators
               use the data as important indicators of our nation’s economic situation
               and to plan and evaluate many government programs.

               In addition, the survey provides current estimates of the economic sta-
               tus and activities of the nation’s population. Because it is not possible to
               develop one or two overall figures (such as the number of unemployed)
               that would adequately describe the whole complex of labor market phe-
               nomena, the survey is designed to provide a large amount of detailed
               and supplementary data. Such data are made available to users of labor
               market information to meet various needs.

               The survey provides the only data available on the distribution of work-
               ers by number of hours worked (as distinguished from aggregate or
               average hours for an industry). This permits separate analyses of part-
               time workers, workers on overtime, and other groups. Also, the survey
               is the only comprehensive, current source of information on the occupa-
               tion of workers and the industries in which they work. Not only is infor-
               mation available for people currently in the labor force, but also for


               Page 16                          GAO/HRD9@97   Uninsured   in Michigan   and in the U.S.
Appendix f
Current Population   Survey




those outside the labor force. Thus, the characteristics of the latter-
including married women with or without young children, disabled per-
sons, students, and older retired workers-can    be determined.

The Current Population Survey was not designed to capture representa-
tive samples of state uninsured populations that would enable users to
make refined estimates of some characteristics of the uninsured.
Because of the many different variables we analyzed on the Michigan
uninsured population, users of this report should exercise caution when
interpreting these data because sampling errors would vary depending
on the sufficiency of the population base. Unless otherwise indicated,
sampling errors for the data in this report were 5 percentage points or
less at the 95-percent confidence level.




Page 17                       GAO/HED90-97   Uninsured   in Michigan and in the U,S,
Appendix II

Uninsured Populations, by Region and                                                                       ’
State (1987)

                                                                  Number of           Uninsured as a
                                                                  uninsured          percent of state
               Region/state                                    (thousand+’                population-
                                  --.
               East North Central
               Illinois                                                   1,326               ‘~__              13
                                    ~.
               Indiana                                                      824          -                      17
               Michigan                                                     861                                 11
               Ohio                                                       1,219                                 13
               Wisconsin                                                    402                                 10
               East South Central
               Alabama                                                     671                                  19
               Kentucky                                                    623                                  19
               Mississippi                                                 535                                  24
               Tennessee                                                   743                                  18
               Middle Atlantic
               New Jersey                                                  736                                  11
               New York
               Pennsylvania                                               1,051                                 11
               Mountain
               Arizona                                                     645                               21
               Colorado                                                    462                               16
               Idaho                                                       178                               21
               Montana                                                     141                               20
               Nevada                                                      188                              7-i
               New Mexico                                                  376                               29
               Utah                                                        223                               15
               Wyoming                                                      60                              -15
               New England
               Connecticut                                                 223                                   9
               Maine                                                       110                                  11
               Massachusetts                                               496                                  10
               New Hampshire                                               114                                  12
               Rhode Island              -                                  88                                  10
               Vermont                                                      59               -13            -
               Pacific
               Alaska                                                       100                               21
               California                                                 5,090                               20
               Hawaii                                                       115                             - 12
               Oregon                                                       443                               19
               Washington                                                   662                               17
                                                                                                   (continued)




               Page 18                       GAO,‘HRD-go-97   Uninsured    in Michigan       and in the U.S.
Appendix II
Uninsured Populations,   by Region and
state (1987)




                                                            Number of             Uninsured as a
                                                            uninsured            percent of state
RegCon/state                                             (thousands)8                 population
South Atlantic                 -^
Delaware                                                             84                          15
District of Columbia                                                107                          21
Florida                                                           2.384                          23
Georgia                             .-                              a41.~_.-__.-                 16
Maryland                                                            508                          13
North Carolina                                                    1,041                          19
South Carolina                                                      460                          16
Virginia                      -.                                    732                          14
West Virginia                                                       271                          17
                                                                                                 ._
West North Central
Iowa                                                                263                    “-     70
Kansas                                                              293                           14
Minnesota                                                           300                            a
Missouri                                                            588               .-          13
Nebraska                                                   -~       191                           14
North Dakota             -                                        -~ 58           -               10
South Dakota                                                        110                           1s
West South Central
Arkansas                       -_                                   552                            26
Louisiana                     -.                                    a37                         -._2i
Oklahoma                                                            651                            23
Texas                                                             3.860               -            26
aExcludes ages 65 and over.




Page 19                                  GAO/HRD90-97 Uninsured    in Michigan     and in the U.S.
Appendix III

Uninsured Rates for Workers (1987) and
tiployment Growth in the United States, by
Industustry
         Group (198547)
                                                                                            Percent of
                                                        Percent of       Employment        employment
                                                        uninsured          Imillions)
               Industry                                     (1987)        1985        1987   grzgi;;
               Public administration                             6         5.39           5.75                  7
               Manufacturing (durable)                           9        13.32          13.09               -2
               Finance, insurance, and real estate               9         7.17           a.07                13
               Mining                                            9         111            0.78              -30
               Transportation, communication, and
               other public utilities                           11        7.97            a.25                     4
               Professional and related services                 a       23.02           24.34                     6
               Wholesale trade                                  11        4.53            4.63                     2
               Manufactunng (nondurable)                        12        8.98            9.08                     1
               Retail trade                                     21       la.32           18.90                 3
               Bwness and repair services                       21         6.57           7.04                 7
               Entertainment and recreation                     21         1.36           1.42                 4
               Construction                                     26         7.82           7.89                 1
               Personal services, includjng private
               households                                       27        4.40            4 56                 4
               Agriculture, forestry, and fisheries             31        3.24            3.26                 1




               Page 20                                GAO/HRLMQ-97   Uninsured    in Michigan    and in the U.S.
Appendix IV

Major Contributors to This Report


                   Janet L. Shikles, Director, Health Financing and Policy Issues,
Human Resources      (202) 275-5451
Division,          Michael F. Gutowski, Assistant Director
Washington, D.G.   James 0. McClyde, Assignment Manager
                   David W. Bieritz, Evaluator-in-Charge
                   Paula J. Bonin, Computer Specialist




(108734)           Page 21                        GAO/HRD--9097   Uninsured   in Michigan   and in the U.S.
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