Insured But Not Protected: How Many Adults Are Underinsured?

TLDR

Health insurance is shifting toward greater financial risk for patients, especially where medical costs are high relative to income, increasing the number of underinsured people. The study estimates that nearly 16 million adults aged 19‑64 were underinsured in 2003, that 35 % of adults (61 million) were under‑ or uninsured, and that underinsured adults were more likely to forgo needed care and experience financial stress comparable to the uninsured, highlighting the need for policy attention to coverage adequacy.

Abstract

Health insurance is in the midst of a design shift toward greater financial risk for patients. Where medical cost exposure is high relative to income, the shift will increase the numbers of underinsured people. This study estimates that nearly sixteen million people ages 19-64 were underinsured in 2003. Underinsured adults were more likely to forgo needed care than those with more adequate coverage and had rates of financial stress similar to those of the uninsured. Including adults uninsured during the year, 35 percent (sixty-one million) were under- or uninsured. These findings highlight the need for policy attention to insurance design that considers the adequacy of coverage.