The Employment Policies Institute (EPI) released a new study which shows that the widely employed estimate of 47 million uninsured Americans is a misleading representation of the problem. The study, authored by Drs. June and David O'Neill of Baruch College and City University of New York, shows that more than 43 percent, or 16 million, of uninsured Americans ages 18-64 could likely afford health coverage and are actually "voluntarily uninsured."

Current policy proposals dramatically overestimate the cost of providing affordable health insurance for those Americans who currently cannot afford coverage due to a lack of understanding of who the involuntarily uninsured population is, why they lack coverage, and the amount of health care resources that they currently access. With greater understanding and recognition of the diversity within the uninsured population, the goal of providing affordable health insurance to all Americans should be possible with solutions that cost far less than the CBO's estimated figure of $1.6 trillion for implementing recent congressional proposals that would only address two-thirds of the problem.

"We urge policymakers not to rush the healthcare debate. This study shows that we need to better understand American's uninsured population and the factors affecting both coverage and access to care," said study author Dr. O'Neill. "This new information about the current uninsured population will increase policymakers' power to target those truly 'at risk,' provide the best coverage and health care access options for each population and decrease the cost of covering the uninsured."

Using data from a number of surveys to determine what percentage of uninsured Americans are actually unable to afford it, the study finds that at least 43 percent of Americans in the 18-64 year-old age group have incomes at least 2.5 times the poverty level and are "voluntarily" uninsured. The study finds that 79 percent of people with incomes between 2.5 and 3.75 times the poverty level currently purchase private health insurance. In view of the large percentages covered at this level, the authors consider this uninsured group as having enough disposable income to purchase health insurance.

"The uninsured are found to obtain about half the amount of health services received by the insured population," said study author Dr. O'Neill. "The lower health status of the involuntarily uninsured could be attributed to their level of education, income, and even lifestyle habits (such as smoking and obesity), more than the mere fact that they do not carry health insurance."

The uninsured population also varies dramatically from state to state. For example, thirty percent of Texas residents are uninsured, compared to 18 percent of New York and 13 percent of D.C. residents. Three states (Texas, Florida and California) make up a third of the uninsured population.

"Instead of focusing on a one-size fits all approach to health care coverage, we should look at what individual states are currently offering and provide additional federal support as needed," said study author Dr. O'Neill.