Summary: More than one in six nonelderly Americans are uninsured today. The lack of insurance coverage does not affect all Americans equally, varying widely among demographic groups as well as geographically. An estimated 42.1 million Americans were uninsured in 1999, which is down from 43.9 million in 1998. Although the decline in the number of uninsured is welcome news, it is too early to know whether this reflects a reversal in the trend. Recent expansions of public programs, such as the implementation of the State Children's Health Insurance Program, and the tight labor market likely contributed to the improved coverage. Even with these positive factors, the number of uninsured remains high, and any significant downturn in economic conditions could lead to a resumption in the growth of their numbers. The uninsured population is a diverse group, including individuals working in different industries and firms of all sizes as well as of different income levels, ages, races and ethnicities, and geographic locations. The heterogeneous nature of the 42 million uninsured Americans suggests that consideration of a combination of strategies must be appropriate in any efforts to expand health insurance coverage.
