Number of underinsured balloons 60 percent, according to a study

A new study from the Commonwealth Fund found that the number of underinsured adults in the United States has increased 60 percent since 2003. The study, published in Health Affairs, analyzed data from a 2007 survey of adults ages 19 and older.

The study defines underinsured adults as “people who have health coverage that does not adequately protect them from high medical expenses.” Survey participants who spent 10 percent or more of their income, 5 percent for low-income participants, on out-of-pocket medical expenses were tagged as underinsured. Participants were also considered underinsured if they had deductibles that totaled 5 percent or more of their income.

Low-income participants were susceptible to being classified as underinsured but middle-income families saw the most impact. The number of underinsured adults who made about $40,000 annually, above 200 percent of the federal poverty level, tripled since 2003. Twenty-five percent of the underinsured adults had per-person annual deductibles of $1,000 or more.

The study also found that 42 percent of the under-65 population, an increase of 35 percent since 2003, had either no insurance or inadequate insurance in 2007.

The study’s authors found correlations between people who are uninsured or underinsured and tendencies to forgo necessary health care. Over half of the underinsured and 68 percent of uninsured went without needed health care such as visiting the doctor when sick or failing to follow up on recommended tests or treatment, compared to 31 percent of insured adults.

The authors of the study suggest that the United States needs to extend “affordable, well-designed” coverage to all.

They concluded: “As health costs continue to grow faster than income and evidence accumulates regarding variable quality and inefficient resource use, there is growing recognition of the need for coherent strategies that combine coverage with payment and other policies to change directions and move toward a more inclusive and higher performing, high-value health system.”