Population Research and Policy Review 19: 97–112, 2000.
© 2000 Kluwer Academic Publishers. Printed in the Netherlands.
Health insurance in the near elderly population
LOUIS G. POL, KEITH J. MUELLER & PHANI TEJ ADIDAM
University of Nebraska, Omaha, Nebraska, USA
Abstract. A number of studies have documented the rising number of persons under age 65
who do not have health insurance. This paper focuses on the health insurance status of near
elderly, those persons age 55 through 64. A comparison age group, persons age 45 through
54, is selected for benchmark purposes. Utilizing data from the 1996 Current Population
Survey, logistic regression is used to generate insurance status prediction equations for both
age groups. Household characteristics, income, education and employment are found to be
signiﬁcant predictors of health insurance status, but fewer-than-expected differences are found
in comparing equations between the two age groups. Results are discussed in the context
of recent proposals to extend Medicare coverage, the effect of Medicare policy changes on
the number of near elderly persons without health insurance, and how prolonged periods of
time without health insurance may lead to an increased burden on Medicare as newly eligible
Medicare recipients seek services to address their pent-up demand for health care.
Keywords: Health insurance, near elderly, medicare, retirement
Post-1990 research has documented a rising number of persons under age
65 without health insurance (e.g., Friedman 1991; Hellander et al. 1995).
From 1987 to 1997 the size of the uninsured population increased from 31.0
to 43.6 million, or by about 41 percent (US Bureau of the Census web site
This rise has been linked to a decline in employer-sponsored health
insurance (Levit et al. 1992; Summer 1994; Holahan et al. 1995; Fronstin &
Snider 1996/1997; Cooper & Schone 1997),
stagnating or falling household
income (Acs 1995), and an increase in the cost of health insurance that cannot
be overcome by growth in wages (Kronick & Gilmer 1999); although the
decline in employer-based coverage has been somewhat offset by a modest
expansion in the number of persons receiving public beneﬁts (Hellander et al.
Several studies have produced analyses of insurance penetration for dif-
ferent age cohorts, including children and adolescents (e.g., Cartland &
Yudkowsky 1993; Newacheck et al. 1995; Fronstin 1995) and the near elderly
(Sloan & Conover 1998; Powell-Griner et al. 1999). This study continues