Why do some people not have health insurance?

Many people don't have access. 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 consider insurance worthwhile if it requires deductibles, copayments, or other forms of high cost-sharing. Alternatively, they may be dissuaded by the complexity of enrolling in coverage or may not know that subsidized coverage is available. The overrepresentation of young adults among the uninsured reflects social, economic and demographic factors. Early adulthood is a period of transition from school to work, likely to involve changes that could lead to gaps in health insurance coverage.

For young adults who are not salaried, family income is a key factor affecting their likelihood of not having insurance. Families covered by employment-based health insurance often extend coverage to children who are supported as full-time college students (usually up to 2 years of age). A family's ability to support one or more children as full-time college students generally reflects moderate or high income levels. Even among full-time college students (6.5 million people), the rate of people without insurance is relatively high among one in five students (about 1.3 million people).

Of the remaining 12 million young adults who are not full-time college students, nearly two out of five people are uninsured (Quinn et al. Market subsidies are mainly provided through premium tax credits, which are generally available to people with an income between 100 and 400 percent of the poverty level, but only if they are legally present in the United States, are they not eligible for public coverage (such as Medicaid or CHIP). ), and not having an affordable offer of employment-based coverage. In recent years, those relationships changed slightly as an increasing number of states expanded eligibility for their Medicaid programs, premiums increased in the non-group market (that is, for plans purchased directly from insurance companies), and the sanction for the individual mandate (a provision) of the ACA ( which required most people to have health insurance) was repealed.

The latter group includes more people who weren't insured for short periods, meaning that the average period of time without coverage is shorter for that group than for people without insurance at any given time. There are many different reasons why people may be left without health insurance for a period, from the cost of coverage to changes in employment. When health insurance is offered to young employees, the employee is more likely to be required to pay a relatively high proportion of the costs. Without legal residency, non-citizens are generally not eligible for public coverage for non-emergency care and cannot purchase insurance (with or without subsidies) through health insurance marketplaces.

National health care reform cannot be achieved unless the federal government places a higher priority on health care than on tax cuts or other spending priorities. An alternative way is to estimate the number of people who don't have insurance at any given time during a given period. It's best for most people to have insurance that can help cover health care costs, such as doctor visits, prescription drugs, and potential emergency room visits; however, it's not always accessible to everyone. About half of the people in this group were eligible for Medicaid, CHIP, or subsidized coverage through marketplaces.

Uninsured people who are eligible for Medicaid or CHIP can generally enroll without paying a premium and could share very low costs in those programs. The conceptual framework developed in this first report will guide the analysis of each report, which will include reviews of health outcomes, financial impacts, and changes in quality of life that result from lack of health insurance. To improve the accuracy of the CPS data, the CBO adjusts variables that are likely to be reported with errors, such as the number of people enrolled in Medicaid and the amount of income reported on tax returns, so that the distributions of the characteristics of the individuals in the HISIM2 sample match with those found in administrative data. .


Lily Prach
Lily Prach

Infuriatingly humble bacon ninja. Lifelong internet specialist. Infuriatingly humble beeraholic. Subtly charming social media junkie. Hipster-friendly food lover.