NCPA - National Center for Policy Analysis

Most Uninsured Spells are Short

December 23, 2003

A total of 84.8 million Americans under age sixty-five were uninsured for at least one month in the four years from 1996 through 1999. National surveys over the past 25 years, however, have shown that there is considerable turnover in the uninsured population over time. High turnover means that many of the approximately 40 million people who are now uninsured will not be among the 40 million who are uninsured a year from now, say researchers Pamela Short and Deborah Graefe.

The authors have found:

  • One out of three people had a lapse in coverage some time between 1996 and 1999.
  • Relatively few of the uninsured were without coverage for the entire four years; only 10.1 million, or 4 percent of the non-elderly population were continuously uninsured.
  • Ten million people moved from being uninsured to some form of insurance and remained insured for the remainder of the 4 years; conversely, 7.3 million people were covered at the start of the survey and moved out of coverage for the rest of the four years.

Because the "repeatedly uninsured" are typically at the low-income levels, where gaps are caused mainly by the instability of employer-sponsored health insurance, policy makers should focus on developing more stable alternatives in the non-group market or under public auspices--specifically for people in the low-income brackets. Employer contributions to public programs to cover the costs of covering individuals who cycle in and out of employer plans may be an option, say the authors.

Source: Pamela Farley Short and Deborah R. Graefe, "Battery-Powered Heath Insurance? Stability in Coverage of the Uninsured," Health Affairs, November/December 2003.


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