Health Affairs

Health Affairs, doi: 10.1377/hlthaff.27.4.w298 (Published online June 10, 2008) © 2008 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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How Many Are Underinsured? Trends Among U.S. Adults, 2003 And 2007

Cathy Schoen ^1*, Sara R. Collins ², Jennifer L. Kriss ³, Michelle M. Doty ⁴

¹ Cathy Schoen is senior vice president of the Commonwealth Fund in New York City.
² Sara Collins is assistant vice president of the Commonwealth Fund.
³ Jennifer Kriss, program associate, the Commonwealth Fund.
⁴ Michelle Doty, associate director of research, the Commonwealth Fund.

^*Corresponding author.

Abstract

With health insurance moving toward greater patient cost sharing, this study finds a sharp increase in the number of underinsured people. Based on indicators of cost exposure relative to income, as of 2007 an estimated twenty-five million insured people ages 19-64 were underinsured--a 60 percent increase since 2003. The rate of increase was steepest among those with incomes above 200 percent of poverty, where underinsurance rates nearly tripled. In total, 42 percent of U.S. adults were underinsured or uninsured. The underinsured report high levels of access problems and financial stress. The findings underscore the need for policy attention to benefit design, to assure care and affordability. [Health Affairs 27, no. 4 (2008): w298-w309 (published online 10 June 2008; 10.1377/hlthaff.27.4.w298)]

Key Words: Access To Care, Business Of Health, Consumer Issues, Health Reform, Insurance Coverage, Health Spending, Insurance Market

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