The number of underinsured adults rose by 60 percent between 2003 and 2007, from 16 million to more than 25 million, according to a new Commonwealth Fund study released June 10 as a Health Affairs web exclusive. Middle- and higher-income families were hit the hardest by the steep increase: Underinsurance rates nearly tripled for those with incomes above 200 percent of the federal poverty level (annual income of $40,000 or higher for a family).
In How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007, Commonwealth Fund authors use 2007 national survey data to provide a national estimate of the number of adults who are underinsured, updating a 2003 study. The analysis finds that 25.2 million insured adults ages 19-64 were underinsured based on their out-of-pocket healthcare costs relative to their incomes. Including those who had any time without insurance during the year, the study estimates that 42 percent of adults age 19-64, or 75 million people, were either uninsured or underinsured during the year as of 2007, up from one-third in 2003.
The study found that despite the fact that the underinsured have health insurance all year long, they are at high risk of access problems and financial stress--with experiences often similar to those of the uninsured. The authors conclude that benefit designs that reduce cost sharing for high-value, cost-effective care and lower cost sharing for families with low and modest incomes will be necessary to achieve high-quality care and better health outcomes rather than just coverage. Read the abstract.
