Report: Unemployment Adds 9 Million Uninsured in U.S.

Nearly 60% looking for an individual plan found it difficult or impossible to obtain, study finds

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, March 16 (HealthDay News) -- The millions of Americans who lost their jobs and their health benefits during the recession often had no way to regain affordable health coverage, leaving them and their families at risk of financial ruin, according to a new report from The Commonwealth Fund.

The spate of layoffs during the recession catapulted 9 million more Americans -- or 57 percent of those who had had health insurance in a job that evaporated over the last two years -- into the ranks of the millions already uninsured.

In addition, 19 million people anxiously seeking private coverage over the last three years were either turned down or could not find a plan that was affordable and met their needs, the report found.

The Biennial Health Insurance Survey also found a whopping 60 percent increase in skipped care due to cost in the past decade. The survey reported that medical debt problems and out-of-pocket spending costs were on the rise as well, with 29 million Americans using up their entire life savings to pay for medical bills and millions more unable to afford food, heat and rent due to medical payments.

"The report tells the story of the continuing deterioration of health care accessibility, efficiency, safety and affordability over the past decade," Commonwealth Fund president Karen Davis said during a noon press conference Tuesday. All this despite the fact that the United States spends more than any other country on health care, she added.

"Most recently it has failed the millions of Americans who lost their jobs during the recession and lost health benefits as well, leaving them with no place to turn for affordable health care coverage," Davis said.

The Commonwealth Fund report focused on the struggles of the 43 million adults under 65 who have lost their health insurance along with their job over the past two years.

"The silver lining is that the Patient Protection and Affordable Care Act has already begun to bring relief to families," Davis added. "Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security."

According to the report, people who lost employer-based health insurance found new coverage exceedingly hard to come by. In fact, only 25 percent of these people were able to find a source for health insurance, and only 14 percent continued their coverage through COBRA (Consolidated Omnibus Budget Reconciliation Act), which allows the employee to buy continued coverage under the employer-based health plan for a limited amount of time.

COBRA, even with increased government participation, is still unaffordable for most people who have lost their job, Davis explained.

Moreover, 71 percent of Americans who tried to purchase an individual plan -- 19 million people -- found it difficult or impossible to find a plan they could afford or that met their needs, or they were turned down or charged extra because of a pre-existing condition, the researchers found.

The problem of the uninsured in the United States has been getting worse. During 2010, some 52 million Americans went without health insurance, compared to 38 million in 2001, the survey revealed.

The hardest hit were adults with family incomes of less than $22,050 for a family of four (54 percent of whom were uninsured) and those with family incomes between $22,050 and $44,100 (41 percent of whom were uninsured). Among those with higher incomes, only 13 percent had no coverage during 2010, the researchers noted.

As health care costs continued to climb, both insured and uninsured had trouble affording care, the report states. In fact, an estimated 75 million Americans skipped doctor visits, prescriptions and recommended tests or treatments in 2010 because of costs. That's up from 47 million in 2001, the researchers noted.

The most likely to skip care were the uninsured, with 66 percent reporting just that. Among people with insurance -- some of whom had high deductibles -- 31 percent skipped care due to cost, the survey found.

Moreover, out-of-pocket costs continue to soar. According to the report, 49 million working adults spent 10 percent or more of their income on these costs and premiums in 2010, an increase from 31 million in 2001.

In addition, health insurance doesn't cover what it used to. A full 31 percent of insured Americans spent 10 percent or more of their income on health care in 2010, up from 19 percent in 2001.

With rising costs comes more medical debt, the report added. In 2010, 73 million Americans reported they had trouble paying for medical care or were saddled with medical debt. That's up from 58 million in 2005, the researchers pointed out.

These debts have forced 29 million people to use their savings to pay medical bills, while 17 million have put these costs on credit cards and 22 million couldn't afford food, heat and rent due to medical bills. In addition, medical bills forced 4 million into bankruptcy, the researchers found.

Some of these problems will be dealt with by the Affordable Care Act. Already the act prevents insurance companies from denying coverage due to a pre-existing condition, allows people up to age 26 to stay on their parents' insurance plans, gives tax credits to small businesses, has no lifetime limits on benefits, and mandates coverage of some preventive care without co-payments.

When the provisions of the law are fully in effect in 2014, almost all of the currently uninsured will have access to comprehensive health insurance through Medicaid or private health plans. There will also be consumer protections and tax credits for those with low and moderate incomes to help them buy insurance.

In addition, health plans will have to meet a basic benefit standard and will not be allowed to deny coverage or charge more because of pre-existing health conditions.

The data for The Commonwealth Fund report were collected by a phone survey of a nationally representative sample of 4,005 U.S. adults between July and November 2010.

More information

For more information on the Affordable Care Act, visit HealthCare.gov.

SOURCES: March 15, 2011, teleconference with Karen Davis, president, The Commonwealth Fund; March 16, 2010, Commonwealth Fund report, Help on the Horizon: How the Recession Has Left Millions of Workers Without Health Insurance, and How Health Reform Will Bring Relief

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