Major Finding: About half of the 59.1 million U.S. adults who reported being uninsured for at least part of the last year were nonpoor, with almost a third making between $43,000 and $65,000 a year (three times the federal poverty level for a family of 4).
Data Source: National Health Interview Survey data from 2006 to 2009 and from January to March 2010.
Disclosures: None reported.
An estimated 59.1 million Americans, including one in four aged 18-64 years, went without health insurance for at least part of the previous year, based on interviews done January-March 2010, the Centers for Disease Control and Prevention reported Nov. 9.
Although the percentage of children and teenagers without health insurance fell slightly, the total number of Americans who lacked insurance at some point in the year increased from 58.7 million in 2009, and the total has risen more than 4% since 2008 (MMWR 2010 Nov. 9 [Early Release]: 1–7)
At the same time, the number of Americans without insurance coverage for more than a year increased by 1.1 million to 33.9 million, the CDC reported.
About 84% of those who reported gaps in their health insurance coverage during the last year were aged 18-64, according to the report.
The number of middle-income adults reporting coverage gaps also increased. About 32% of adults under age 64 living in middle-income families – those with incomes of approximately $43,000-$65,000 for a family of four – reported being uninsured for at least part of the previous 12 months, indicating that problems with insurance coverage are extending further into the middle class.
“All of our measures of uninsurance have increased and increased substantially,” Dr. Thomas Frieden, director of the CDC, said in a press conference.
The CDC conducted in-person interviews of a sample of the population during the first quarter of 2010 in an effort to determine the number of uninsured.
It found that “half of the uninsured are nonpoor,” Dr. Frieden said. About 21% make more than three times the federal poverty level (FPL), defined as $65,000 for a family of four, and 9% make more than four times the FPL, or $87,000 for a family of four.
Meanwhile, the percentage of children and teenagers without health insurance fell slightly from 2008 to 2010, from 13% to 12%, according to the report.
The number of chronically uninsured children and teens – those who lacked health insurance for all of the prior year – dropped by 700,000, indicating that efforts to extend coverage to uninsured children through the Children's Health Insurance Program (CHIP) are paying off, the report found.
Being uninsured raised the risk of going without needed care substantially, especially for adults, according to the report. For those aged 18-64 years, those with no health insurance during the preceding year were seven times as likely − 28%, compared with 4% – to forego needed health care because of cost. Uninsured adults who had been diagnosed with diabetes were six times more likely − 47% vs. 8% – to skip necessary care because of cost.
The findings in the report represent a significant problem for the 40% of Americans adults with a chronic disease, Dr. Frieden said.
“Middle-aged adults who don't get preventive care enter Medicare sicker,” said Dr. Frieden, resulting in more hospitalizations and higher costs, especially for those with chronic conditions such as diabetes.