FIGURE 3.1 Work status of the family head for the 35.7 million Americans under age 65 who were without health insurance, 1990. (See glossary for definition of work status categories.) SOURCE: Adapted from EBRI, 1992d. Reproduced with permission from EBRI Issue Brief Number 123, Sources of Health Insurance and Characteristics of the Uninsured, analysis of the March 1991 Current Population Survey.

ment-based coverage, compared with three-quarters of those with higher incomes (EBRI, 1992a). For all workers aged 18-64 earning less than $10,000 a year in 1991, about 30 percent had indirect employment-based coverage and 16 percent had direct coverage. This group includes many part-time workers (Long and Marquis, 1992). Decreases in employment-based coverage in the period 1988 to 1990 were concentrated among low-wage workers.

Young workers are also less likely to have coverage than older workers. An Urban Institute analyst working from March 1988 CPS data found that 42 percent of workers aged 18 to 24 were without employment-based coverage, compared with about 20 percent of those aged 35 to 44 (Swartz, 1992).

The numbers above are conservative because they include only those who were without insurance for all of 1990, not those who were uninsured for only a portion of the year. When Census Bureau analysts looked at their data for a 28-month period starting in 1987, they found that some 61 million people spent at least one month without insurance from any public or private source (Rich, 1992).

Workers or their family members may lack coverage for several reasons. A worker's employer (1) may not offer coverage at all, (2) may offer coverage only to selected categories of workers, such as those who work over some number of hours per week, (3) may require an employee contribution to the premium that the worker is unable or unwilling to pay, or (4) may exclude the worker or family member because of a preexisting health



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