HealthAffairsUninsured

HealthAffairsUninsured - Health Tr a c k i n g M a r k e t...

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MarketWatch The Uninsured And The Affordability Of Health Insurance Coverage Examining subgroups of uninsured Americans uncovers certain patterns of coverage gaps, but affordability remains a key concern. by Lisa Dubay, John Holahan, and Allison Cook ABSTRACT: The 2005 Current Population Survey (CPS) is used to estimate what share of uninsured Americans are eligible for coverage through Medicaid or the State Children’s Health Insurance Program (SCHIP), need financial assistance to purchase health insur- ance, and are likely able to afford insurance. Twenty-five percent are eligible for public cov- erage, 56 percent need assistance, and 20 percent can afford coverage. This varies across uninsured populations: 74 percent of children are eligible for public programs, and 57 per- cent and 69 percent of parents and childless adults, respectively, need assistance. A cen- tral conclusion is that a large percentage of uninsured adults need help purchasing health insurance. [ Health Affairs 26, no. 1 (2007): w22–w30 (published online 30 November 2006; 10.1377/hlthaff.26.1.w22)] D uring the past five years, the number of uninsured Americans in- creased by more than six million, ris- ing from 39.6 million in 2000 to 46.1 million (nonelderly) in 2005. 1 This is a major policy concern for a number of reasons. To begin with, lack of insurance coverage has adverse effects on the uninsured themselves. Despite being in worse health status than people with coverage, the uninsured use fewer services and face higher out-of-pocket spending than their insured counterparts. 2 Moreover, medi- cal expenses by the uninsured have been shown to be an important contributor to U.S. bankruptcy filings. 3 In addition, hospitals and other providers face increasing demands for care by the uninsured for which there is little or no reimbursement. This places fiscal stress on these institutions and on the local governments and philanthropies that sup- port them. The predominant vehicle for health insur- ance coverage in the United States is employ- ers, which cover 161 million nonelderly people. Another large source of coverage, particularly for low-income people, is Medicaid, which covers children, parents, the disabled, and in some states, other adults. Children and some adults, mostly parents, also receive coverage through the State Children’s Health Insurance Program (SCHIP). Together, Medicaid and SCHIP provide insurance to almost thirty mil- lion people. 4 Another fourteen million people obtain coverage through the direct purchase market, and others are covered through Medi- care and military health insurance programs. Together these various types of insurance ex- tended coverage to 209.5 million Americans in w 2 2 3 0 N o v e m b e r 2 0 0 6 H e a l t h T r a c k i n g DOI 10.1377/hlthaff.26.1.w22 ©2006 Project HOPE–The People-to-People Health Foundation, Inc.
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