Does chronic illness affect the adequacy of health insurance coverage?

Although chronically ill individuals need protection against high medical expenses, they often have difficulty obtaining adequate insurance coverage due to medical underwriting practices used to classify and price risks and to define and limit coverage for individuals and groups. Using data from healthy and chronically ill individuals in Indiana, we found that chronic illness decreased the probability of having adequate coverage by about 10 percentage points among all individuals and by about 25 percentage points among single individuals. Preexisting condition exclusions were a major source of inadequate insurance, though not the only cause. Our results emphasize the impact of enforcing the Health Insurance Portability and Accountability Act (HIPAA) of 1997, which limits preexisting condition exclusions.