While the number of medically uninsured young adults dropped over the past two years, coverage of the overall working age population failed to improve, according to the findings of the Commonwealth Fund’s 2012 biennial health insurance survey released Friday.
The survey shows that 11.7 million young adults – ages 19 to 25 – were uninsured for any time in 2012, 1.9 million fewer than in 2010. That is a drop from 48 to 41 percent in that age group and a shift from a decade-long climb in the uninsured rate, according to the survey. The report’s authors credit the provision in the federal health law that allows young adults to stay on their parents’ health plan until the age of 26.
Dr. Sara Collins, a vice president at the Commonwealth Fund and the lead author of the report, said in an interview that “this has really been a high risk population. They’ve always had the highest rates of uninsurance, so this is a major change for this age group. .. It’s really a positive change.”
But that decline was not mirrored in other age groups.
In 2012, approximately 84 million adults – or 46 percent of those aged 19 to 64 – did not have health insurance coverage for the entire year or were considered underinsured, which the authors said means their coverage does not provide adequate protection from medical costs. This number has grown from 61 million in 2003 and 81 million in 2010, when Commonwealth last surveyed on the issue.
The authors attribute the growth to the rising costs of health care and increasing rates of unemployment that occurred following the economic meltdown in 2008.
According to the report, low- and moderate-income adults were most at risk of being uninsured or underinsured.
In a Thursday conference call with reporters, Dr. David Blumenthal, president of the Commonwealth Fund, said that the survey “shows the continuation of the bad news that sparked the move to reform our dysfunctional health care system.” He added that the findings “point clearly to the need to move forward with implementation” of the federal health law.
But Edmund Haislmaier, a senior research fellow in health policy studies for The Heritage Foundation, which opposes the law, raised a concern about trying to assess the number of people who are underinsured. In comments Thursday before seeing the study, he said, “There’s no standard definition of underinsured. Underinsured is simply their subjective opinion and one should put very little weight on that.”
“It’s a matter of debate as to how comprehensive insurance coverage should be,” he added. “It’s very subjective.”
Aside from facing gaps in health coverage or being underinsured, the report also notes that millions in the United States are burdened with medical debt. According to the survey, 75 million adults struggled to pay their medical bills or indicated they were paying off medical-related debt over time. In this group, 42 percent, or 32 million adults, said they received a lower credit rating as a result of unpaid medical bills.
In that conference call, Collins said that “the Affordable Care Act’s new insurance coverage options slated to roll out in 2014 have the potential to significantly reduce the numbers of people who are uninsured and underinsured.” As an example, she referred to the estimated 55 million adults in the survey who were uninsured in 2012 and said that “more than half have incomes that would make them eligible for coverage under the law’s Medicaid expansion if they are legal residents.”
But, according to Collins, a key challenge is the large number of states considering not expanding their Medicaid programs.
“If some states don’t expand their program as intended, millions of people in low-income families will remain uninsured,” she said.
The poll of 4,432 adults was conducted by Princeton Survey Research Associates International from April 26 to August 19, 2012 and has a margin of error of +/- 2.3 percentage points. Researchers limited the report’s analysis to 3,393 survey respondents between ages 19 to 64.