In the News

Health Insurance Deficient $25 million

Story by Arkansas Democrat Gazette

The number of people in this country who have health insurance but not the ability to afford adequate medical care continues to climb.

About 25 million Americans - or about one of every five adults younger than age 65 with health insurance - did not have sufficient coverage last year to shield them from financial hardship if they ended up in the emergency room or were seriously ill, according to a new study released Tuesday by the Commonwealth Fund.

"We're moving in a direction where you can be insured all year and still face medical bankruptcy," said Cathy Schoen, the study's lead author and a senior vice president for research and evaluation at the Commonwealth Fund, a private foundation in New York supporting research and initiatives to improve health care.

The relentless rise in the cost of medical care, combined with a growing number of insurance plans that require patients to pay a higher portion of their medical bills, has led to a 60 percent increase in the number of underinsured adults from 2003-07, according to the study. The Commonwealth Fund first calculated the number of underinsured in 2003 when it estimated that 16 million Americans did not have sufficient coverage.

As the nation debates how best to improve its health-care system, including how to insure the increasing number of Americans without coverage, policymakers also need to discuss the quality of available coverage, said Karen Davis, the president of the Commonwealth Fund.

"Lack of insurance is only part of the problem, as even the insured have serious gaps in coverage," she said.

The study, published by the medical policy journal Health Affairs, also indicates that the sharpest increase in the underinsuredwere middle-class families whose coverage still left them vulnerable to medical costs equal to 10 percent more of their incomes. While coverage offered by large companies remains fairly generous, people who attempt to buy individual policies or who are covered through small companies increasingly must settle for policies that require high deductibles or that sharply limit the benefits as ways of reducing the cost of the premiums.

Like the approximately 50 million uninsured Americans, the underinsured often choose to forgo necessary medical care, the study indicated. Twice as many people who are underinsured said they did not fill a drug prescription or see a recommended specialist for care, the survey found, compared with the number of people who had more generous coverage.

The fund's estimate is based on a survey conducted last year of adults under 65 years old who had insurance throughout the year. Individuals were considered underinsured if their outof-pocket medical expenses were 10 percent of their incomes, or 5 percent if they were low-income adults or had insurance deductibles that exceeded 5 percent of their incomes.

Return to July Newsletter