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Cost-based Underinsurance After the Affordable Care Act
Journal of Health Care for the Poor and Underserved
|November 28, 2023
Summary
Millions of insured Americans remain underinsured, facing significant financial risks despite coverage. Medicaid beneficiaries experienced less underinsurance, highlighting gaps in current health insurance adequacy for lower-income adults.
Area of Science:
- Health Services Research
- Health Economics
- Public Health Policy
Background:
- The Affordable Care Act reduced uninsured rates, but underinsurance persists.
- Millions of insured Americans face financial risks due to inadequate health coverage.
- Existing underinsurance definitions may not fully capture financial burden.
Purpose of the Study:
- To analyze the association between insurance types, demographics, and cost-related underinsurance.
- To examine underinsurance among continuously insured, lower-income adults in the U.S.
- To incorporate subjective financial burden into the underinsurance definition.
Main Methods:
- Analysis of a nationally representative sample of continuously insured, lower-income adults.
- Extended definition of underinsurance including subjective financial burden.
- Statistical analysis of insurance types and demographic factors.
Main Results:
- 33.2% of lower-income individuals in the sample were underinsured.
- A quarter of underinsured individuals met two or three underinsurance criteria.
- Medicaid beneficiaries showed significantly lower rates of underinsurance compared to other groups.
Conclusions:
- Underinsurance remains a significant concern for lower-income adults.
- Insurance coverage expansion alone may not eliminate financial risks and cost barriers.
- Policy interventions should address the adequacy of health insurance coverage.
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