Health insurance coverage is up, but many still uninsured or underinsured

While the number of Americans who lack health insurance is nearing historic lows, many of these changes came about because of policy changes enacted to help boost coverage during COVID-19, according to a survey from The Commonwealth Fund. However, a large number of patients are inadequately covered, and this situation will only worsen when temporary pandemic measures expire.

The survey found that in 2022, 43% of working-age adults were inadequately insured. They were either uninsured (9%), had a coverage gap (11%), or their coverage didn’t provide them with affordable access to health care (23%). The vast majority (79%) of people who were uninsured when surveyed had been without any coverage for a year or longer. People who lacked coverage for a year or more were disproportionately poor, young, and Latinx/Hispanic; in fair or poor health or living with a chronic health problem; and/or living in the South.

For those with employer coverage, 29% were underinsured, with the number jumping to 44% for those with coverage purchased through the individual marketplace.

These uncovered costs are affecting patient care, according to the survey, with 46% of respondents saying they had skipped or delayed care because of cost, and 42% said they had problems paying medical bills or were paying off medical debt. Almost half (49%) said they would be unable to pay for an unexpected $1,000 medical bill within 30 days, including 68% of adults with low income, 69% of Black adults, and 63% of Latinx/Hispanic adults.

Cost-saving measures taken by patients included not going to the doctor when sick, skipping a recommended follow-up visit or test, not seeing a specialist when recommended, or not filling a prescription.

Large numbers of voters say the president and congress should make health care a top priority: 68% of Democrats, 55% of independents, 46% of Republicans.

The survey used data from 6,301 respondents aged 19 to 64.