One in four adults experienced gaps in health coverage last year

Commonwealth Fund: Uninsured residents struggled to find individual insurance

Topics: Finance, Payer and Regulatory Policy, Market Trends, Strategy

April 20, 2012

One in four U.S. residents ages 19 to 64 experienced gaps in insurance coverage at some point in 2011, and nearly 70% of those residents had been uninsured for one year or longer, according to a survey by the Commonwealth Fund.

The survey of 2,134 U.S. adults also found that uninsured U.S. residents struggled to obtain coverage through the individual market. Of those respondents who sought coverage in the individual market during the previous three years:

  • 62% said they found it very difficult or impossible to find an affordable policy;
  • 38% said it was hard to find the coverage they required;
  • 31% said they were turned down, charged a higher copayment or had a pre-existing condition excluded from coverage; and
  • 73% reported some type of issue when purchasing a plan.

A majority of survey respondents also said they had difficulty comparing plans' costs and benefits.

Those difficulties resulted in fewer individuals obtaining coverage, according to the report. Of the roughly 18.5 million U.S. residents who shopped for insurance in the individual insurance market in the last three years, just 10.2 million bought coverage, leaving 8.3 million people without insurance.

Individual market a 'weak, stop-gap' solution, survey concludes
The survey concluded that the individual market is a "weak, stop-gap" option for uninsured U.S. residents to obtain health coverage. Commonwealth Fund President Karen Davis noted that gaps in care and an inability to gain coverage can have "potentially serious implications for [respondents'] health as they lose contact with health care providers, skip needed care and recommended preventive care and screening tests."

The survey noted that the federal health reform law, which aims to close the insurance gap, has begun to address the issue (Levey,  Los Angeles Times, 4/19; Sternberg, "Second Opinion," U.S. News & World Report, 4/19; Bristol, CQ HealthBeat, 4/19 [subscription required]).

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