Too often, discussions of health care reform center on vague assumptions about who the uninsured are, which leads to distorted policy solutions.

Many people counted among the uninsured ranks are recent immigrants, as documented in this Employee Benefits Research Institute study.

Also, a large percentage of the uninsured are young adults, ages 19 to 30, who are often in good health and would gain far less in health benefits than they would pay in premiums (see this study from the Commonwealth Fund for the numbers — but not necessarily the remedy!). Others are low-income people who are eligible for Medicaid and SCHIP but who don’t sign up for these programs. And then there are those who can afford coverage but choose to self-insure.

This is not to suggest that there aren’t many uninsured families who want, and need, insurance but go without because they are not eligible to enroll in anything affordable. These families often work for smaller businesses that either don’t offer coverage or offer plans with premiums that are too expensive for low wage workers.

The health care reform debate frequently occurs without regard to these elementary facts. That kind of factual vacuum can lead to flawed policy.