$45 billion a year is spent by public on health costs for full-time workers and families

The study reveals a growing divide in the health system between low-wage and higher-wage earners between 1996-2003. While higher-wage workers made substantial gains in their use of preventive care services over the period of the study, lower-wage workers made only modest gains or suffered declines in preventive care. They were also less likely to be using the latest generation of prescription drugs. Consequently, the health care spending gap between high- and low-wage workers has widened considerably.

“Without insurance coverage, people don’t get the care they need when they are sick, and the preventive care they need to keep them from getting sick in the first place,” said lead author Sherry Glied, Professor and Chair of the Department of Health Policy and Management of Columbia University's Mailman School of Public Health. “When private employer-sponsored coverage declines, public health insurance and uncompensated care only fill part of the gap. We need expanded health insurance coverage to ensure that everyone has access to the benefits of health care.”

Additional Findings from Health Insurance, Health, and Low-Wage Workers:

• There is a widening gap in insurance coverage between low- and higher-wage workers: in 1996, 22 percent of low-wage workers were uninsured compared to 6 percent of higher-wage workers; by 2003 nearly a third of low-wage workers were uninsured with no change in the share of uninsured higher-wage workers.
  
  
• The gap in insurance coverage mirrors a growing gap in access to health care between low- and higher-wage workers. In 2003, 81 percent of higher-wage workers had their blood pressure checked in the last year, up from 77 percent in 1996. In contrast, only 66 percent of lower-wage workers had had their blood pressure checked in the last year, down from 70 percent in 1996.
  
  
• Similarly, in 1996, low-wage workers reporting a routine check-up was just 5 percentage points lower than similar reports by high-wage workers. By 2003, however, lower-wage workers lagged higher-wage workers in reports of routine check-ups by 15 percentage points.
  
  

“While these studies underscore the crucial role of public programs in filling gaps in employer coverage, many workers are falling further behind in access to critical health care services,” said Sara Collins, assistant vice president for the Future of Health Insurance at The Commonwealth Fund. “This points to the need for universal health insurance to ensure that everyone has access to needed care.”

Both studies concluded that the growing lack of employer provided health care is placing a larger burden on taxpayers, working families, especially lower-wage workers, and public health insurance programs.

“If we want to move the United States toward the high performance health care system Americans want and deserve, the first step is to get all Americans insured,” says Commonwealth Fund President Karen Davis. “In order to do that, the public and private sectors must work together to share responsibility for providing health care coverage.”

The Commonwealth Fund is an independent foundation working toward health policy reform and a high performance health system.