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Study Indicates Health Insurance Gap for 48 Million Americans

Source: WSJ

Posted on 20 Apr 2012

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Health insuranceA quarter of working-age adults had a gap in their health-insurance coverage last year, mainly because they lost or changed their jobs, a new think-tank study says.

One in four people between the ages of 19 and 64 were uninsured or had only recently regained coverage when they were interviewed in the summer of 2011, a survey for the non-partisan Commonwealth Fund found.

That translates to about 48.2 million people, analysts of the data said.

Commonwealth Fund researchers said the survey also showed how hard it can be for consumers to buy insurance on the individual market in its current form. Almost two-thirds of respondents said they couldn’t find policies they could afford, and others said they had problems because of their medical history.

“The individual market has proven to be a weak stop-gap option for families who lose employer insurance,” the researchers wrote.

And an early provision of the health-overhaul law passed in March 2010 — “high-risk pools” for sick people to buy insurance — hadn’t helped many people, they added.

Although a majority of respondents in the survey said they knew about it, only about 6% of them had tried to get coverage through the program, which, has tricky eligibility requirements.

The survey’s tally of people with coverage gaps came in higher than previous ones: Census data show about 41.2 million 19-64 year old adults in 2010 were uninsured. Those numbers, however, were based on whether people lacked coverage at the specific time they were interviewed.

Including children and some elderly people not covered by Medicare, the Census found there were 50 million people uninsured at the time they were interviewed in 2010. (Other estimates of this number are lower.)

In the Commonwealth Fund survey, the most common reason people said they didn’t have insurance was that they had previously got it through an employer but lost it after being laid off, changing jobs, or becoming part-time workers. Only a few respondents said they had lost coverage because their employer had stopped offering benefits.

Some respondents said they had previously had government-funded coverage through the Medicaid program for low-income Americans, but lost it because their income changed or they grew too old to qualify.

Researchers said a provision of the 2010 overhaul law that lets parents include children on their plans until their 26th birthday had closed coverage gaps for some people.

In all, researchers said that the health-overhaul law would make it easier for people to replace lost coverage, either by shopping for policies through new insurance exchanges after 2014 (with government subsidies towards the premiums), or, for some poor adults, through Medicaid.