more than the overall population (U.S. Census Bureau, 2008).4 Yet many Hispanic workers are employed in industries associated with low wages and limited health benefits, such as sales, building and grounds cleaning and maintenance, and food preparation and serving (Kochhar, 2005).5 Rutledge and McLaughlin analyzed 20 years of pooled SIPP data to assess the trends in uninsurance among Hispanics (Rutledge and McLaughlin, 2008). They found that the decline in coverage among Hispanics occurred among both U.S. born and immigrants and was primarily driven by a decrease in private coverage.

THE FORCES BEHIND THE DOWNWARD SPIRAL IN HEALTH INSURANCE COVERAGE

Rising Costs Are Driving the Decline in Health Insurance Coverage

Most analysts agree that rising health care costs are the principal force driving the declines in health insurance coverage (Chernew et al., 2005; Cooper and Schone, 1997; Holahan and Cook, 2008). Health care costs—in both the private and public sectors—have been growing faster than the overall economy for decades. In 2006, health care spending averaged $7,026 per person in the United States (Catlin et al., 2008; Centers for Medicare & Medicaid Services Office of the Actuary, 2008b).

From 2000 to 2006, per capita health care spending grew by 47 percent compared to the 34 percent increase in gross domestic product (Centers for Medicare & Medicaid Services Office of the Actuary, 2008c). The trend is expected to continue (Congressional Budget Office, 2008; Ginsburg, 2008; Paulson et al., 2008; U.S. Government Accountability Office, 2008). The Centers for Medicare & Medicaid Services projects that total U.S. health care spending will almost double between 2008 and 2017 (Keehan et al., 2008).

Employer-Sponsored Insurance

Health insurance has been associated with the workplace ever since the 1930s when it was introduced as a fringe benefit of employment (Moran, 2005). However, the rapid growth in health care costs has made it increasingly difficult for employers to offer health coverage for their workers.

4

This compares with 64.4 percent of the total U.S. population over age 15 in the civilian labor force.

5

For additional research on health insurance trends in the Hispanic population, also see: Buchmueller et al. (2007); Fronstin (2008a,b); Hargraves (2004); Holahan and Cook (2005).



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement