Millions have health coverage gaps -- Commonwealth Fund study

The instability hurts patients' continuity of care and boosts health system costs.

By Joel B. Finkelstein, amednews staff. Dec. 1, 2003.

Washington -- As if 43 million uninsured Americans weren't enough, it turns out that nearly twice that number have gone without health coverage at some point, according to the Commonwealth Fund.

An analysis of U.S. Census Bureau data from 1996 to 1999 showed that during that time, 84.8 million Americans had no insurance for periods ranging from one month to the entire four years. Additionally, 33% of those people went without insurance several times during the study period.

"We used to think this was a 15% problem, that roughly 15% to 17% of the population under 65 was uninsured," said Karen Davis, president of the Commonwealth Fund. "It's a 40% problem, and in fact, it's a 70% problem among low-income people."

Nearly 70% of Americans under 200% of the poverty level lacked insurance at some point during the four years, according to the analysis, which was published in the November-December Health Affairs.

"A lot of people cycle repeatedly in and out of being uninsured," said lead author Pam Farley Short, a professor of health policy and administration at Pennsylvania State University in University Park. "There are about 28 million people, one-third of those who were ever uninsured, who fell into that pattern."

By looking at four years of data together, this pattern of insurance gaps was revealed. The researchers concluded that this poses several problems, both for patients and the health care system in general.

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