Most Americans have health insurance through their employers, yet employment is no longer a guarantee of
health insurance coverage. As America continues to move from a manufacturing-based economy to a
service economy, and employee

Source: Chart taken from Kaiser Family Foundation at www.kff.org:
Kaiser Commission on Medicaid and the Uninsured and Urban Institute
analysis of the 2008 ASEC Supplement to the Current Population Survey.

working patterns continue to
evolve, health insurance coverage
has become less stable. The
service sector offers less access to
health insurance than its
manufacturing counterparts.

Due to rising health insurance
premiums, many small employers
cannot afford to offer health
benefits. Companies that do offer
health insurance, often require
employees to contribute a larger
share toward their coverage. As a
result, an increasing number of
Americans have opted not to take
advantage of job-based health
insurance because they cannot
afford it.

Several studies estimate the number of uninsured Americans. According to the U.S. Census Bureau, nearly 47 million Americans, or 20 percent of the population under the age of 65, were without health insurance in 2008, their latest data available.1

The Agency for Healthcare Research and Quality, using the Medical Expenditure Panel Survey (MEPS)
estimated that the percentage of uninsured Americans under age 65 represented 27 percent of the
population. According to the MEPS data, nearly 54 million Americans under the age of 65 were uninsured
in the first-half of 2007.2

A recent study shows that based on the effects of the recession alone (not job loss), it is projected that
nearly seven (7) million Americans will lose their health insurance coverage between 2008 and 2010.3
Urban Institute researchers estimate that if unemployment reaches 10 percent, another six (6) million
Americans will lose their health insurance coverage. Taking these numbers together, it is conceivable that
by next year, 57 to 60 million Americans will be uninsured.

Even if employees are offered coverage on the job, they can\u2019t always afford their portion of the premium. Health insurance premiums have increased 131 percent for employers since 1999 and employee spending for health insurance coverage (employee\u2019s share of family coverage) has increased 128 percent between 1999 and 2008.7

Rapidly rising health insurance premiums are the main reason cited by all small firms for not offering
coverage. Health insurance premiums are rising at extraordinary rates. The average annual increase in
inflation has been 2.5 percent while health insurance premiums for small firms have escalated an average of
12 percent annually.7

Studies estimate that the number of excess deaths among uninsured adults age 25-64 is in the range of
22,000 a year. This mortality figure is more than the number of deaths from diabetes (17,500) within the
same age group.8

Lack of insurance compromises the health of the uninsured because they receive less preventive care, they are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than insured individuals.9

The uninsured are increasingly paying \u201cup front\u201d -- before services will be rendered. When they are unable to
pay the full medical bill in cash at the time of service, they can be turned away except in life-threatening
circumstances.12

Access to an emergency room for uninsured patients does not qualify as access to coordinated care. While
physicians are required to stabilize patients in an emergency, they are not required to treat the condition
comprehensively.1 3