Study reveals coverage gaps and corresponding drop-offs in care

A new Commonwealth Fund study, released April 19, shows the pervasive problem of health coverage gaps among adult Americans. According to the study, one in four working-age U.S. adults experienced a gap in health insurance coverage during 2011, in many cases because they lost or changed jobs.

The Commonwealth Fund based its report on national survey findings. In addition to uncovering the gap, the study also reveals how difficult it is for people to regain health insurance after losing employer-sponsored coverage.

“This shows that people are really dependent on their jobs for healthcare coverage, and with how the economy has been the last few years, there are just fewer jobs,” said Sara Collins, vice president of the Commonwealth Fund and lead author of the 2011 Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults. “People find it difficult to find individual health plans that they can afford.”

According to Collins, 70 percent of survey respondents who went through a period without health insurance lacked coverage for a year or longer. Of those respondents, 57 percent were uninsured for two years or more.

Compared with adults who had continuous coverage, those who experienced any gaps were less likely to have a regular doctor and less likely to be up to date with recommended preventive care tests, with rates declining as the length of the coverage gap increased. “Under half of those people who went uninsured had a regular doctor or were up to date on tests,” said Collins.

The major provisions of the health reform law that will go into effect starting in 2014 are expected to help bridge coverage gaps and make insurance more affordable, noted Collins. Those provisions include an expansion in eligibility for Medicaid, subsidies for purchasing private plans through new health insurance exchanges, and rules preventing insurers from denying coverage or charging more based on gender or a pre-existing condition.

“This part of the Affordable Care Act focuses on the new insurance exchanges to help offset the costs for people,” Collins said. “About 45 percent of people who shopped for an individual health plan in the last three years did not end up buying a plan. Of those people, 62 percent said they didn’t purchase a plan because the premiums were too high.”

Follow HFN Associate Editor Kelsey Brimmer on Twitter @kbrimmerhfn.

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