Health Affairs

Posting date: June 14, 2005

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Health Affairs, 10.1377/hlthaff.w5.289
Copyright © 2005 by Project HOPE

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Insured But Not Protected: How Many Adults Are Underinsured?

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

¹ Cathy Schoen is a vice president of the Commonwealth Fund in New York City.
² Michelle Doty is a senior analyst at the Commonwealth Fund.
³ Sara Collins is a senior program officer at the Commonwealth Fund.
⁴ Alyssa Holmgren is a program assistant at the Commonwealth Fund.

^*Corresponding author.

Abstract

Health insurance is in the midst of a design shift toward greater financial risk for patients. Where medical cost exposure is high relative to income, the shift will increase the numbers of underinsured people. This study estimates that nearly sixteen million people ages 19-64 were underinsured in 2003. Underinsured adults were more likely to forgo needed care than those with more adequate coverage and had rates of financial stress similar to those of the uninsured. Including adults uninsured during the year, 35 percent (sixty-one million) were under- or uninsured. These findings highlight the need for policy attention to insurance design that considers the adequacy of coverage.

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

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