Working but Uninsured: Benefits Not Included

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Health Insurance

Study suggests official figures understate deficit in health insurance coverage

The number of uninsured Americans may be greater than the commonly reported figure of 46 million, according to a new study released by Sen. Tom Harkin (D-Iowa). In a household survey of fringe benefits available to U.S. workers in part-time, temporary, contract and on-call positions, the authors found that medical discount cards were commonly mistaken for health insurance. It also found that such "nonstandard" jobs provide few fringe benefits such as health insurance.

The study, "Nonstandard Jobs, Substandard Benefits," was conducted by the Iowa Policy Project (IPP) and completed under a grant from the U.S. Department of Labor and additional funding through The Commonwealth Fund.

"I commend IPP for highlighting the lack of health insurance offered to the growing legion of temporary workers in America and for addressing the critical need for health care access by the working poor. It is disgraceful that we are the only industrialized nation that does not provide its citizens with access to health insurance," Sen. Harkin said.

"Rather than excessive, irresponsible tax breaks for the wealthy we need to invest in health coverage for our nation. Health care should be a fundamental right, not a luxury."


The study suggests that the official government survey tracking health insurance coverage nationwide understates the number of Americans without health insurance. That survey fails to identify individuals who report having insurance but in fact possess only a medical discount card.

Discount cards, as opposed to health insurance policies, offer very limited benefits and consumers are responsible for paying all claims and the full cost of services up front.

"If the government's survey on health insurance coverage is going to remain relevant, they must find a way to include questions about new types of health insurance and non-insurance products," said Peter Fisher, research director of the IPP. Fisher co-authored the report with Elaine Ditsler and Colin Gordon of the IPP and David West of the Center for a Changing Workforce in Seattle, Wash.

With about 1 in 4 workers in a nonstandard job, nonstandard work has contributed to the decline in job-based health insurance and the increasing numbers of uninsured Americans since 2000, the IPP survey found.

Among findings of the report from the Mount Vernon, Iowa-based IPP: