Opening Statement of the Hon. Nancy Johnson, M.C., Connecticut,
and Chairwoman, Subcommittee on Health

Hearing on the Nation's Uninsured

April 4, 2001

Today's hearing focuses on uninsured Americans and solutions for expanding health insurance coverage. Two years ago, in a similar hearing on the uninsured, the Health Subcommittee found that a record number of Americans were uninsured. This year, for the first time in more than a decade, the percentage of Americans with health insurance has increased -- almost two million more Americans no longer lack health insurance. The main source for the decline was a strong economy and a low unemployment rate.

However, 42 million Americans - more than1 in 6 Americans - remain uninsured. The uninsured are a blight on the nation's health care system. This committee understands the importance of addressing this problem because those without health coverage often go without health care. Indeed, the uninsured are more than four times as likely to delay care, use 40 percent fewer services than the insured individuals with similar health, and experience a mortality rate 25 percent greater than insured individuals with similar characteristics. Moreover, without affordable health insurance, these Americans run the risk of financial catastrophe. Finally, their costs are often shifted to Medicare and private payors, creating distortions in the market.

The uninsured are a diverse group. More than four out of five uninsured are full time workers and their families, and one out of five uninsured individuals work for employers who offer coverage but they choose not to take it. The primary reason cited for these workers being uninsured was the cost of insurance. Providing more resources to these people will clearly help them purchase insurance.

Many of the uninsured -- one-fourth of adults and 2/3 of children -- are eligible for public programs but fail to enroll. While there are many complex issues involved reasons why eligible individuals do not enroll in public problems, according to the Commonwealth Fund, the majority of the uninsured would prefer not to have government be the main source of coverage.

Today, we will hear testimony from researchers at the Employee Benefit Research Institute and the Health Research and Education Trust on trends in health insurance coverage and who has coverage and who does not; about who is uninsured in America and why they are uninsured. We will also hear their analysis about whether the favorable trend in insurance coverage will continue.

The second panel will turn to examining potential options for increasing coverage for the 42 million uninsured Americans, and focus on tax ideas, in particular. The panelists will discuss their evaluation of the effect of tax credits as well as other options.

President Bush has proposed a multi-prong strategy to assist the uninsured. Two key components of his proposals to reduce the uninsured, for which Ways and Means has jurisdiction, are tax credits and medical savings accounts. In that vein, we will be examining tax credit ideas in this hearing. Secondly, Committee Chairman Bill Thomas will introduce the Medical Savings Account Availability Act today.

In addition, we will be working with our colleagues on other committees of jurisdiction to attack this problem, by seeking ways to make insurance more affordable through group purchasing structures, improving the enrollment in S-CHIP and expanding access to community health centers.

The hearing will provide a framework for the development of legislation to address the barriers faced in accessing health insurance coverage by the uninsured. And I look forward to working with the Bush Administration and our Democratic colleagues on reducing the number of Americans without health insurance.