Barely Hanging On

Middle-Class and Uninsured - A State-by-State Analysis

The two recessions that Americans have weathered in the first decade of the 21st century have taken a tremendous toll on people’s ability to afford health insurance—and employers’ capacity to offer it. This new report, Barely Hanging On: Middle-Class and Uninsured, documents that while the situation has been tough for everyone, it’s America’s middle class that has been hardest hit.

The report shows that the number of middle-income earners who obtained health insurance from their employers dropped by 3 million people from 2000 to 2008. Just 66 percent of people in families earning roughly $45,000 to $85,000 are now insured through their employer—a drop of seven percentage points from 2000 to 2008.

Employer-sponsored insurance (ESI) has long been the mainstay of health coverage for middle-class families, who typically do not qualify for government insurance programs. Among middle-income Americans, only about half of the decline in employer-sponsored coverage from 2000 to 2008 was offset by government insurance programs. For people who earned less money, declines in ESI were even steeper, but those numbers were mostly offset by increases in coverage through government insurance programs like Medicaid.

The report is being released during Cover the Uninsured Week (March 14-20), a campaign organized by RWJF to advocate for health coverage for all Americans. Now in its eighth year, it is the largest, nonpartisan mobilization in history seeking solutions for the millions of Americans who are uninsured.