An Estimated 116 Million Adults Were Uninsured, Underinsured, Reported a Medical Bill Problem, and/or Did Not Access Needed Health Care Because of Cost,

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THE COMMONWEALTH FUND Rising Health Care Costs: Implications for the Health and Financial Security of U.S. Families Sara R. Collins, Ph.D. Assistant Vice.

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THE COMMONWEALTH FUND 1 An Estimated 116 Million Adults Were Uninsured, Underinsured, Reported a Medical Bill Problem, and/or Did Not Access Needed Health.

THE COMMONWEALTH FUND 1 Figure 1. We Can’t Continue on Our Current Path: Growth in the Uninsured Data: Analysis of the U.S. Census Bureau, Current Population.

Reforming Health Care: Making Sense of Health Care Finance amid Growing Underinsurance Leonard Rodberg, PhD Urban Studies Dept., Queens College/CUNY Prepared.

31 million adults ages 19–64 years who had a coverage gap

Insured Women Are More Likely to Receive Cancer Screenings Than Uninsured Women, 2016 Percent of women Notes: “Continuously insured” refers to adults.

Adults with Medical Bill Problems Had Lingering Financial Problems

Subsidized private insurance

More Than One-Quarter of Insured Adults Were Underinsured in 2016

Adults Insured All Year with Medicaid Coverage Reported Lower Rates of Medical Bill Problems Than Adults with Private Coverage and Those Uninsured During.

Uninsured Adults and Those with Coverage Gaps Reported Medical Bill Problems at Higher Rates Than Did Those Continuously Insured, 2016 Percent of adults.

Uninsured Adults and Those with Coverage Gaps Reported Cost-Related Access Problems at Higher Rates Than Did Those Continuously Insured Percent of adults.

Adults ages 19– Uninsured now 15%

State Uninsured Rates by Poverty and Firm Size

Adults ages 19–64 who are uninsured or have individual coverage

Fewer Women Say They Are Not Getting Needed Care Because of Costs

Across Income Groups, Increasing Numbers of U. S

Percent adults ages 19–64 insured all year who were underinsured*

Percent of adults ages 19–64 who are uninsured

Adults in California and New York Reported Lower Rates of Cost-Related Access Problems Than Those in Florida and Texas Percent of adults ages 19–64 U.S.

Uninsured Adults Are Less Likely to Receive Cancer Screenings, 2016

Percent of adults ages 19–64

Two of Five Adults Ages 50–64 Who Have or Tried to Buy Individual Insurance Were Turned Down, Charged a Higher Price, or Excluded Because of a Preexisting.

Insured all year Total (%) Number (in millions) Uninsured anytime (%)

Percent adults ages 19–64 with a health problem or condition^

Percent of adults ages 19– In the past 12 months:

The Number of Adults Without Insurance, Forgoing Health Care Because of Cost, and Paying Large Shares of Their Income on Health Care Has Increased, 2001–2010.

Seventy-Five Percent of Uninsured Adults Ages 50–64 Reported a Cost-Related Problem Getting Needed Care Percent of adults ages 50–64 Rtoopf5 rtcsf10 newdebt.

Deductibles Have Become a Growing Factor in Underinsurance Rates

Underinsured Rates Among Adults Who Were Insured All Year by Source of Coverage at the Time of the Survey Percent adults insured all year ages 19–64 who.

Uninsured and Underinsured Adults with Chronic Conditions Are More Likely to Visit the ER for Their Conditions Percent of adults ages 19–64 with at least.

Inadequate Coverage Is Associated with More Problems Paying Medical Bills Percent of adults ages 19–64 who had medical bill or debt problems in past year*

Women Are More Likely to Have Access Problems and Medical Bill Problems in Past Year, 2007 Percent of adults ages 19–64 reporting the following problems.

Percent of adults ages 19–64

Adults Ages 19–64 Who Are Uninsured and Underinsured, By Poverty Status, 2007 *Underinsured defined as insured all year but experienced one of the following:

Percent uninsured 200% FPL or more 32% Less than 100% FPL 39% 100%–

Percent of adults ages 19– In the past 12 months:

Medical Bill Problems and Accrued Medical Debt, 2005–2007

16 Million Adults Under Age 65 Were Underinsured in 2005

Percent of adults ages 19–64 with at least one chronic condition*

Adequately insured 48% Uninsured anytime 15% Uninsured anytime 36%

Inadequate Coverage Is Associated with More Cost-Related Problems Getting Needed Care Percent of adults ages 19–64 who had any of four access problems.

25 Million Adults Underinsured in 2007, Up from 16 Million in 2003

Subsidized private insurance

Cost-Related Access Problems and Medical Bill Problems Are Significantly Higher Among Latinos Uninsured During the Year Percent Latino adults ages

Medicaid <133% FPL 26 million

Medical Bill Problems or Medical Debt

Percent of adults ages 19–

Two of Five Adults Uninsured or Underinsured 25 Million Underinsured 60 Percent Increase in Underinsured from 2003 to 2007 Percent of adults (ages 19–64)

Adults Ages 19–64 Who Are Uninsured and Underinsured, by Poverty Status, 2003 *Underinsured defined as insured all year but experienced one of the following:

Percent of adults ages 19–64 Total <200% FPL 200% FPL or more

The Number of Underinsured Adults Under Age 65 Rose to 25 Million in 2007, Up from 16 Million in 2003 Percent of adults ages 19– Total.

Percent of adults (ages 19–64)

Problems with Medical Bills or Accrued Medical Debt Increased, 2005–2007 Percent of adults ages 19–64 with medical bill problems or accrued medical debt.

Uninsured during the year

Uninsured and Underinsured Adults with Chronic Conditions Are More Likely to Visit the ER for Their Conditions Percent of adults ages 19–64 with at least.

Percent of adults ages 19–64 who had any of four access problems

Medical Bill Problems and Accrued Medical Debt, 2005–2007

Percent of adults ages 19–64

More Than Three of Five Adults Who Selected a Private Plan or Enrolled in Medicaid Were Uninsured Prior to Gaining Coverage What type of health insurance.

Insured now, time uninsured during year

Percent of adults ages 19–64

Percent of adults (ages 19–64)

Percent adults insured all year ages 19–64 who were underinsured*

Percent of adults ages 19–64 insured all year who were underinsured

Reasons for Loss of Employer-Sponsored Insurance and Medicaid

High Deductibles Relative to Income by Coverage Source at the Time of the Survey Percent with deductibles that are 5% or more of income, adults ages 19–64.

Percent of currently employed adults ages 19–64

The Number of Adults Reporting Not Getting Needed Care Because of Cost Declined in 2014 for the First Time Since 2003 Percent of adults ages 19–

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An Estimated 116 Million Adults Were Uninsured, Underinsured, Reported a Medical Bill Problem, and/or Did Not Access Needed Health Care Because of Cost, 2007 Medical bill/debt problem 17.7 million 10% Adequate coverage and no bill or access problem 61.4 million 35% Medical bill/debt and cost-related access problem 54.4 million 31% Uninsured anytime during the year or underinsured 17.6 million 10% Cost-related access problem 25.9 million 15% 177 million adults, ages 19–64 Source: S. R. Collins, J. L. Kriss, M. M. Doty, and S. D. Rustgi, Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families—Findings from the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2007 (New York: The Commonwealth Fund, Aug. 2008).