Rate For Young Adult Health Care Coverage Improves While Others Decline: Commonwealth Fund

Eighty-four million people―nearly half of all working-age U.S. adults―went without health insurance for a time last year or had out-of-pocket costs that were so high relative to their income they were considered underinsured, according to the Commonwealth Fund 2012 Biennial Health Insurance Survey. The report, Insuring the Future: Current Trends in Health Coverage and the Effects of Implementing the Affordable Care Act, noted that the proportion of young adults ages 19 to 25 who were uninsured during the year fell from 48 percent to 41 between 2010 and 2012, reversing a nearly decade-long trend of rising uninsured rates in that age group. This reversal is likely due to a provision in the Patient Protection and Affordable Care Act (ACA) allowing young adults to stay on their parents’ health insurance until age 26, the Commonwealth Fund noted.

The report found that the percentage of Americans who were uninsured, underinsured, or had gaps in their health coverage grew steadily between 2003 and 2010, with the number of underinsured nearly doubling from 16 million in 2003 to 29 million in 2010. However, between 2010 and 2012, the numbers of underinsured adults leveled off, growing to 30 million. The Commonwealth Fund believes that this is partly a result of slower health care cost growth and lower overall health spending by consumers, combined with declining household incomes. But provisions in the ACA—such as requiring insurers to cover recommended preventive care without any cost to patients—also are beginning to make health care more affordable for many consumers.

“The early provisions of the ACA are helping young adults gain coverage and improving the affordability of health care during difficult economic times for American families,” said Sara Collins, Commonwealth Fund vice president. “It will be critical to continue to monitor the effects of the law as the major provisions go into effect in 2014 and beyond to ensure it achieves its goal of near-universal, comprehensive health insurance.”

The survey found the following:

• In 2012, about three-fourths of working-age adults with low incomes (less than $14,856 a year for an individual or $30,657 for a family of four)—an estimated 40 million people—were uninsured or underinsured.

• Fifty-nine percent of adults with moderate incomes (between $14,856 and $27,925 for an individual or between $30,657 and $57,625 for a family of four)—or 21 million people —were uninsured or underinsured.

• Adults who were uninsured were less likely to receive recommended preventive care in 2012. For example, only 48 percent of women who were uninsured during the year received a mammogram within the recommended period, compared to 77 percent of those who were well insured all year.

Impact of the ACA. The ACA is not fully implemented until Jan. 1, 2014, and the bulk of the law’s effects will not be felt until then. The Commonwealth Fund used the survey’s findings to determine how the ACA will impact Americans currently uninsured or underinsured, and found the following:

• Eighty-seven percent of the 55 million people who were uninsured for some time during the year in 2012 have incomes that would make them eligible for subsidized health insurance through the insurance marketplaces or expanded Medicaid under the law, though coverage is limited to those legally present in the U.S.

• Up to eighty-five percent of the 30 million underinsured adults might be eligible for either Medicaid or subsidized health insurance plans with reduced out-of-pocket costs under the law.

The survey contains responses from 4,432 adults ages 19 and older living in the continental U.S. For more information, visit http://www.commonwealthfund.org/Publications/Fund-Reports/2013/Apr/Insuring-the-Future.aspx.

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