Technical Appendix
Definitions for Tables 1, 2, 4, and 5 and Figure 1
Individual Health Insurance
Individual health insurance was defined as private health insurance that was obtained from sources other than an employer or union, including coverage from some other group, such as an association, as well as from non-group sources, such as an insurance company or HMO (health maintenance organization) and coverage identified as being obtained by self-employed individuals with no employees.
Employment-related Health Insurance
Employment-related coverage was defined as including health insurance obtained through an employer or union. It also includes coverage through someone outside of the household or coverage whose source was unknown, since both sources are likely to be employment related.
Other Public Insurance
Individuals were classified as having other public insurance if they reported insurance from other public hospital/medical coverage that was not Medicaid and if they reported TRICARE (Armed Forces related) coverage.
Appendix Tables
General statistics that serve as the basis for Figures 5-10 in the body of the text are shown in Tables A1, A2, and A3.
Table A1. Percentage of adults in families with out-of-pocket spending on health care and health insurance premiums exceeding 10% of after-tax income, by insurance and age, 2005
| Age | Variable Label | Private Group | Private Nongroup | Public | Uninsured | ||||
|---|---|---|---|---|---|---|---|---|---|
| Mean | Standard Error | Mean | Standard Error | Mean | Standard Error | Mean | Standard Error | ||
| Total | After-tax family income | 59,343 | 667 | 52,499 | 2,166 | 17,331 | 462 | 26,790 | 866 |
| OOP spending on care | 1,394* | 30 | 2,071 | 234 | 1,226 | 204 | 1,016* | 71 | |
| OOP premiums | 2,041* | 47 | 4,549* | 223 | 227* | 20 | 160 | 16 | |
| Total OOP burden | 3,435* | 59 | 6,620* | 335 | 1,453* | 205 | 1,176* | 75 | |
| % in families w/ high burdens | 18.7* | 0.6 | 52.6* | 2.9 | 25.0* | 1.3 | 15.2* | 0.9 | |
| 25-34 | After-tax family income | 50,841* | 1,065 | 42,092 | 4,040 | 17,928 | 748 | 22,922 | 933 |
| OOP spending on care | 798* | 33 | 1,052* | 185 | 336* | 48 | 499* | 43 | |
| OOP premiums | 1,505* | 54 | 2,239* | 240 | 90* | 15 | 115 | 25 | |
| Total OOP burden | 2,304* | 67 | 3,291* | 371 | 427* | 53 | 614* | 51 | |
| % in families w/ high burdens | 12.2* | 0.9 | 34.2* | 6.2 | 11.3* | 1.7 | 10.6* | 1.3 | |
| 35-44 | After-tax family income | 63,160* | 1,140 | 55,895 | 3,995 | 17,948 | 1,053 | 29,045 | 1,428 |
| OOP spending on care | 1,248* | 50 | 1,310* | 182 | 1,728 | 805 | 1,007* | 112 | |
| OOP premiums | 2,164 | 90 | 3,707* | 390 | 133* | 28 | 158 | 37 | |
| Total OOP burden | 3,412* | 100 | 5,017* | 477 | 1,861 | 805 | 1,165* | 119 | |
| % in families w/ high burdens | 16.4* | 0.9 | 40.8* | 6.7 | 18.9* | 2.7 | 13.5* | 1.7 | |
| 45-54 | After-tax family income | 63,151* | 929 | 58,924 | 4,532 | 16,615 | 791 | 30,814* | 1,724 |
| OOP spending on care | 1,654* | 51 | 3,147 | 762 | 1,137* | 125 | 1,320 | 164 | |
| OOP premiums | 2,101* | 75 | 5,682 | 474 | 277* | 47 | 198 | 33 | |
| Total OOP burden | 3,756* | 100 | 8,830 | 946 | 1,414* | 142 | 1,518 | 174 | |
| % in families w/ high burdens | 19.4* | 1.1 | 60.8 | 5.4 | 28.5* | 2.7 | 17.0* | 1.8 | |
| 55-64 | After-tax family income | 58,396 | 1,253 | 51,905 | 3,454 | 16,761 | 1,071 | 25,674 | 1,597 |
| OOP spending on care | 1,894 | 79 | 2,432 | 236 | 1,776 | 191 | 1,743 | 283 | |
| OOP premiums | 2,381 | 95 | 5,975 | 510 | 437 | 61 | 210 | 41 | |
| Total OOP burden | 4,275 | 126 | 8,406 | 568 | 2,214 | 213 | 1,953 | 286 | |
| % in families w/ high burdens | 28.0 | 1.3 | 69.0 | 4.0 | 43.9 | 2.8 | 25.4 | 2.6 | |
Source: 2006 Medical Expenditure Panel Survey—Household Component
Notes:* indicates estimates that are significantly different from those in the 55-64 year old category (p<0.05). " OOP" refers to out-of-pocket and " high burdens" refers to out-of-pocket costs for medical care and premiums that exceed 10% of the family's after-tax income. The family is defined as a " Health Insurance Eligibility Unit," which generally refers to an individual and a spouse and children, if present. Each person is assigned the income and costs of the unit. Individuals were classified into one health insurance category based on the type of coverage for which they had the most number of months in 2005. Uninsured individuals were uninsured throughout 2005. Premium amounts were prorated for the number of months of coverage
Table A2. Percent of adults with no medical visits and average visits, by health insurance status, condition, and health status: 2003-2006
| Condition/Health Status | Insured Full Year | Insured Part Year | Uninsured Full Year | Insured Full Year | Insured Part Year | Uninsured Full Year | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| % No visits | SE | % No visits | SE | % No visits | SE | Avg # visits | SE | Avg # visits | SE | Avg # visits | SE | |
| Ages 25-54 | ||||||||||||
| All persons | 22.24^ | 0.32 | 31.78*^ | 0.78 | 53.90*^ | 0.79 | 8.08^ | 0.12 | 6.48*^ | 0.23 | 5.33*^ | 0.17 |
| Depression | 5.49^ | 0.46 | 11.22*^ | 1.41 | 27.45* | 2.33 | 14.80^ | 0.46 | 10.98*^ | 0.84 | 9.46* | 0.88 |
| Diabetes | 6.29^ | 0.68 | 6.07 | 1.55 | 19.19*^ | 2.84 | 13.45 | 0.72 | 9.70* | 0.90 | 6.49* | 0.63 |
| Heart disease | 3.60^ | 0.55 | 6.99 | 1.98 | 16.62* | 2.88 | 14.04 | 0.62 | 9.54* | 0.87 | 7.87* | 0.99 |
| Hypertension | 6.68^ | 0.49 | 9.97* | 1.36 | 15.85* | 1.61 | 11.13^ | 0.37 | 9.15 | 1.23 | 6.03* | 0.46 |
| Any chronic condition | 8.81^ | 0.28 | 14.00*^ | 0.82 | 27.71*^ | 1.06 | 9.91^ | 0.16 | 7.87*^ | 0.34 | 6.75* | 0.28 |
| Trauma | 7.39^ | 0.46 | 13.65*^ | 1.34 | 23.85* | 1.43 | 11.51^ | 0.30 | 8.22*^ | 0.43 | 7.12* | 0.48 |
| No chronic condition | 39.32 | 0.52 | 48.72* | 1.10 | 67.93* | 0.86 | 4.59 | 0.10 | 4.26 | 0.20 | 3.61* | 0.20 |
| Health: exc./vg/good | 23.72^ | 0.33 | 34.79*^ | 0.85 | 57.15*^ | 0.86 | 7.01^ | 0.11 | 5.65*^ | 0.24 | 4.51*^ | 0.16 |
| Health: fair/poor | 7.96^ | 0.57 | 13.18* | 1.36 | 32.72*^ | 1.51 | 16.68 | 0.51 | 10.35* | 0.62 | 8.74* | 0.63 |
| SF-12 physical health ≤40 | 5.09^ | 0.43 | 10.79* | 1.44 | 24.64* | 1.72 | 18.45 | 0.54 | 11.65* | 0.62 | 10.33* | 0.65 |
| SF-12 physical health >40 | 22.15^ | 0.34 | 32.44*^ | 0.89 | 55.17*^ | 0.88 | 6.86^ | 0.10 | 5.68*^ | 0.26 | 4.40* | 0.18 |
| SF-12 mental health ≤40 | 11.06^ | 0.50 | 17.87 | 1.59 | 38.81 | 1.70 | 13.23^ | 0.39 | 9.31*^ | 0.45 | 7.96* | 0.62 |
| SF-12 mental health >40 | 21.79^ | 0.36 | 32.52^ | 0.92 | 54.40^ | 0.90 | 7.45^ | 0.12 | 5.87*^ | 0.29 | 4.76*^ | 0.17 |
| Ages 55-64 | ||||||||||||
| All persons | 11.65 | 0.44 | 19.26* | 1.58 | 37.59* | 1.68 | 10.93 | 0.23 | 8.84* | 0.55 | 6.51* | 0.42 |
| Depression | 3.19 | 0.55 | 3.95 | 1.80 | 22.30* | 4.25 | 17.94 | 1.06 | 16.31 | 2.28 | 9.03* | 1.02 |
| Diabetes | 2.67 | 0.44 | 8.17* | 2.47 | 7.78* | 2.34 | 14.67 | 0.63 | 9.83* | 1.01 | 8.38* | 0.79 |
| Heart disease | 1.63 | 0.33 | 2.87 | 1.78 | 11.10* | 2.97 | 15.58 | 0.63 | 11.64* | 1.27 | 9.99* | 1.09 |
| Hypertension | 3.94 | 0.34 | 7.98* | 1.69 | 13.77* | 2.05 | 12.30 | 0.32 | 9.27* | 0.75 | 7.21* | 0.54 |
| Any chronic condition | 4.84 | 0.29 | 8.24* | 1.11 | 18.82* | 1.60 | 11.90 | 0.26 | 9.69* | 0.63 | 7.05* | 0.47 |
| Trauma | 4.53 | 0.66 | 6.16 | 2.06 | 23.18* | 3.52 | 16.51 | 0.64 | 15.61 | 2.09 | 8.50* | 1.08 |
| No chronic condition | 38.89 | 1.35 | 52.27* | 4.22 | 66.19* | 2.25 | 4.90 | 0.28 | 3.99 | 0.58 | 4.54 | 0.88 |
| Health: exc./vg/good | 13.09 | 0.50 | 22.38* | 1.98 | 41.47* | 1.85 | 9.32 | 0.22 | 7.85* | 0.63 | 5.66* | 0.45 |
| Health: fair/poor | 4.48 | 0.57 | 9.66* | 2.36 | 24.88* | 2.78 | 18.17 | 0.75 | 11.46* | 1.46 | 8.69* | 0.84 |
| SF-12 physical health ≤40 | 3.35 | 0.49 | 6.90 | 2.07 | 23.93 | 2.78 | 18.70 | 0.76 | 12.64 | 1.27 | 9.58 | 0.95 |
| SF-12 physical health >40 | 11.97 | 0.52 | 21.81 | 2.27 | 39.96 | 2.15 | 8.81 | 0.21 | 7.20 | 0.60 | 5.04 | 0.40 |
| SF-12 mental health ≤40 | 7.28 | 1.00 | 14.11 | 3.44 | 31.77 | 3.38 | 17.48 | 1.11 | 12.58 | 1.36 | 8.05 | 1.00 |
| SF-12 mental health >40 | 10.35 | 0.45 | 17.89 | 1.84 | 36.31 | 1.91 | 10.37 | 0.22 | 8.19 | 0.65 | 6.15 | 0.47 |
Source: Pooled Data from the 2003-2006 Medical Expenditure Panel Survey—Household Component
* indicates the estimate is statistically different than the estimate for the full-year insured at the 5% level.
^ indicates that the estimates for ages 25-54 are statistically different from the estimates for ages 55-64 at the 5% level. SE is standard error.
Table A3. Percent of adults reporting a delay in medical care/prescription drugs, by health insurance status, condition, and health status: 2003-2006
| Condition/Health Status | Insured Full Year | Insured Part Year | Uninsured Full Year | Insured Full Year | Insured Part Year | Uninsured Full Year | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| % MD delay | SE | % MD delay | SE | % MD delay | SE | % RX delay | SE | % RX delay | SE | % RX delay | SE | |
| Ages 25-54 | ||||||||||||
| All persons | 4.41^ | 0.18 | 12.01* | 0.63 | 12.76* | 0.62 | 3.46^ | 0.14 | 8.01^ | 0.50 | 7.80* | 0.51 |
| Depression | 10.96 | 0.69 | 25.82* | 2.21 | 30.71* | 2.56 | 10.87 | 0.55 | 22.28 | 1.83 | 24.33*^ | 1.98 |
| Diabetes | 8.15 | 0.84 | 27.76* | 4.15 | 21.92* | 3.41 | 9.82 | 1.00 | 25.49 | 3.20 | 21.02*^ | 3.28 |
| Heart disease | 9.71 | 0.95 | 21.63* | 3.29 | 29.03* | 3.65 | 7.85 | 0.91 | 23.67 | 3.30 | 21.54*^ | 3.25 |
| Hypertension | 6.35 | 0.49 | 19.93*^ | 2.04 | 22.99* | 2.09 | 7.01 | 0.54 | 19.39^ | 2.11 | 20.78*^ | 2.21 |
| Any chronic condition | 6.42 | 0.28 | 18.78* | 1.02 | 22.36*^ | 1.18 | 5.61 | 0.22 | 14.66 | 0.90 | 16.46*^ | 1.00 |
| Trauma | 7.88 | 0.48 | 15.75* | 1.46 | 22.75* | 1.60 | 5.78 | 0.37 | 11.03 | 1.25 | 12.96* | 1.30 |
| No chronic condition | 1.85 | 0.14 | 5.57*^ | 0.55 | 7.62* | 0.47 | 0.72 | 0.10 | 1.66 | 0.25 | 3.16* | 0.33 |
| Health: exc./vg/good | 3.50^ | 0.17 | 9.28* | 0.58 | 10.11* | 0.57 | 2.59 | 0.13 | 5.43^ | 0.39 | 5.58* | 0.47 |
| Health: fair/poor | 13.17^ | 0.74 | 28.92* | 1.92 | 30.04* | 1.66 | 11.86 | 0.64 | 23.97 | 1.97 | 22.27* | 1.49 |
| SF-12 physical health ≤40 | 14.08^ | 0.77 | 30.51* | 2.21 | 33.93* | 2.28 | 12.71 | 0.77 | 25.66* | 2.34 | 23.84* | 1.66 |
| SF-12 physical health >40 | 3.60 | 0.17 | 10.01* | 0.69 | 10.74* | 0.59 | 2.70^ | 0.14 | 5.85* | 0.47 | 6.05* | 0.54 |
| SF-12 mental health ≤40 | 11.12 | 0.69 | 24.17* | 1.57 | 29.45* | 1.88 | 9.38 | 0.57 | 19.24* | 1.49 | 21.72* | 1.65 |
| SF-12 mental health >40 | 3.71^ | 0.17 | 9.83* | 0.72 | 10.04* | 0.55 | 2.89^ | 0.14 | 5.75*^ | 0.53 | 5.22*^ | 0.43 |
| Ages 55-64 | ||||||||||||
| All persons | 5.27 | 0.30 | 12.67* | 1.33 | 13.94* | 1.04 | 4.94 | 0.30 | 11.30 | 1.24 | 9.00* | 0.84 |
| Depression | 10.10 | 1.09 | 27.78* | 5.04 | 25.42* | 3.60 | 10.25 | 1.05 | 19.63 | 4.03 | 16.01 | 3.17 |
| Diabetes | 7.42 | 0.82 | 17.67* | 3.72 | 16.79* | 3.03 | 8.36 | 0.90 | 20.30 | 3.82 | 12.16 | 2.29 |
| Heart disease | 8.38 | 0.85 | 18.17* | 4.23 | 22.12* | 4.00 | 9.56 | 0.94 | 18.78 | 4.26 | 11.00 | 2.97 |
| Hypertension | 5.33 | 0.43 | 12.98* | 2.10 | 17.85* | 2.12 | 6.64 | 0.54 | 12.39 | 1.91 | 13.45* | 1.76 |
| Any chronic condition | 5.95 | 0.35 | 16.09* | 1.73 | 17.96* | 1.45 | 6.04 | 0.37 | 14.28 | 1.56 | 12.81* | 1.24 |
| Trauma | 8.76 | 0.78 | 20.60* | 4.51 | 21.96* | 2.93 | 7.04 | 0.79 | 12.32 | 3.05 | 13.31* | 2.43 |
| No chronic condition | 2.56 | 0.45 | 2.42 | 1.10 | 7.81* | 1.19 | 0.54 | 0.16 | 2.39 | 1.13 | 3.20* | 0.69 |
| Health: exc./vg/good | 4.34 | 0.30 | 9.46* | 1.29 | 10.06* | 1.02 | 3.54 | 0.27 | 8.75 | 1.38 | 6.66* | 0.90 |
| Health: fair/poor | 9.87 | 0.90 | 22.55* | 3.08 | 26.63* | 2.48 | 11.92 | 0.88 | 19.17 | 2.62 | 16.67* | 1.84 |
| SF-12 physical health ≤40 | 11.39 | 0.90 | 25.31 | 3.38 | 27.24 | 2.79 | 11.20 | 0.85 | 20.77 | 2.87 | 19.43 | 2.28 |
| SF-12 physical health >40 | 3.67 | 0.29 | 7.94 | 1.44 | 9.21 | 1.04 | 3.58 | 0.31 | 7.54 | 1.46 | 5.69 | 0.79 |
| SF-12 mental health ≤40 | 10.20 | 1.06 | 26.38 | 4.24 | 27.67 | 3.00 | 10.93 | 1.12 | 17.36 | 3.41 | 18.85 | 2.70 |
| SF-12 mental health >40 | 4.79 | 0.31 | 10.09 | 1.57 | 11.28 | 1.12 | 4.56 | 0.33 | 10.26 | 1.47 | 7.46 | 0.87 |
Source: Pooled Data from the 2003-2006 Medical Expenditure Panel Survey—Household Component
* indicates the estimate is statistically different than the estimate for the full-year insured at the 5% level.
^ indicates that the estimates for ages 25-54 are statistically different from the estimates for ages 55-64 at the 5% level. SE is standard error.


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