The lack of insurance has been attributed to several factors, such as rising health care costs, the economic recession, the erosion of employer-based insurance, and cuts in public programs. Developing effective strategies to reduce the lack of insurance requires understanding why people lack insurance coverage. Uninsured people have different reasons for not getting health insurance. The most common is the cost of health insurance premiums.
The CBO estimates that approximately one-third of uninsured single adults would have to pay more than 10 percent of their income for health insurance. Uninsured people may not think insurance is worth it if it requires high deductibles, co-pays, or other forms of cost-sharing. Alternatively, they may be deterred by the complexity of enrolling in coverage, or they may not know that subsidized coverage is available. Uninsured Americans also miss opportunities to plan their finances more easily, especially those who want preventive care or need prescription drugs.
Most say that cost is the main reason they don't have health insurance. It's unfortunate because not having insurance can be more expensive if a medical emergency occurs. Other causes include a complicated process, lack of familiarity with available plans, and loss of employment. Many uninsured people receive primary care through community health centers, which charge heavily discounted rates to low-income patients, or through other protective clinics or local health departments.
We focus on coverage for people who are not older, since Medicare offers nearly universal coverage for older people, since only 407,000, or less than 1%, of people over 65 are uninsured. Get health insurance through an employer, but not all workers are offered employer-sponsored coverage or, if offered, can afford their share of the premiums. A short period without insurance exposes people to the financial risk of experiencing unexpected health events that could occur during that time, but it has a more limited effect on their access to routine and early care. Community health centers, many of which are funded in part by federal grants, provide comprehensive primary care services and use an income-based sliding scale to set patient rates.
For example, children under 19 from low-income families may be eligible for the Children's Health Insurance Program (CHIP) or Medicaid. The CBO believes that these people are uninsured, even if they are eligible to immediately enroll in a government plan or program that would retroactively pay for health care expenses they previously incurred. These plans offer very limited protection against expensive medical events to people who can't afford deductibles, co-pays, or other associated charges, which can amount to hundreds or thousands of dollars. The value of that deduction is much less than the combined value of excluding income and payroll tax premiums and employer contributions available to people who are covered through an employer.
Third, some of the people that the CBO classifies as uninsured people have partial protection against costly medical events because they are enrolled in a non-comprehensive health plan or are eligible for coverage under a plan offered by their previous employer. There are some situations where you may need to not receive medical care for a short time, but preventive care is the best way to avoid more serious problems. Research shows that people substantially increase their use of health care services after obtaining health insurance. .
