Where you live, who you work for, and what color you were born are predictors of whether you have health insurance in America.

New data from those hard-working, non-partisan researchers at the Employee Benefits Research Institute (EBRI) have published their latest portrait of insured, and uninsured, Americans. The report is based on data from the March 2007 Current Population Survey of the U.S. census. For the details, see EBRI Issue Brief No. 310, October 2007.

Geography is destiny as a factor for being insured. The highest level of uninsurance is in the south central US, where about 20% of the population lacked health insurance in 2006. EBRI points out that in many of these states, lower average income and higher unemployment rates contribute to uninsurance. States with the highest percentage of uninsured include Arizona, Florida, Oklahoma, New Mexico, and Texas.

Race and ethnicity are factors in uninsurance.
White people are more likely to receive employment-based health insurance than people of other races. EBRI notes, “Even after controlling for poverty status, whites nearly across the board were more likely to have employment-based coverage than other races/ethnicities.”

Occupation type determines whether you’ll have health insurance. Uninsured workers were most likely to be employed in the wholesale and retail trade or service industries, which collectively account for 55% of jobs in the U.S.

Size (of employer) matters. If your employer is large, you’ll more likely get offered health insurance than if your employer is small. Large employers can provide health benefits at a lower cost than small employers because they cover the health risks of more people – and thus, are subject to less adverse selection. The costs of plan administration and marketing are also lower for larger companies.

Self-employment is a precursor to being uninsured.
Nearly two-thirds of uninsured workers are self-employed or in small companies with fewer than 100 employees.

Health Populi’s Hot Points: New job formation tends to be among smaller companies, and smaller companies don’t tend to offer health insurance due to the “size matters” metric. Those of us who bravely start new businesses on our own, the self-employed cadre of which I’ve been a member for 15 years, are at a lonely and financially draining disadvantage when it comes to finding and funding health insurance on our own. And the continuing challenge of health disparities between white Americans vis-à-vis non-white Americans is alive and unwell in this sad saga of uninsurance in America.

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