87M Adults Were Uninsured or Underinsured in 2018, Survey Says


MORE AMERICANS ARE insured than in the past, but millions are enrolled in skimpy health plans that often keep them from seeking care, according to a new report from The Commonwealth Fund.
Researchers estimate that in 2018, 45 percent of working-age adults, or 87 million people, were either under insured or had no coverage for at least part of the last year – a share that is essentially unchanged from 2010, despite monumental shifts in health policy during that time.
The Affordable Care Act, which was enacted in 2010 and saw key provisions put in effect in 2014, expanded Medicaid eligibility and subsidized coverage for millions of Americans who were low-income or didn't have access to health insurance through their employers, but largely left employer-based coverage alone. Nearly 20 million people gained access to health coverage as a result.
Yet the country also is now grappling with a larger pool of people who are under insured – meaning they have health coverage, but also have high out-of-pocket health care costs relative to their incomes and are more likely to put off care or struggle to pay medical expenses, according to the report.
"U.S. working-age adults are significantly more likely to have health insurance since the ACA became law in 2010," Sara Collins, lead author of the study and The Commonwealth Fund's vice president for health care coverage and access, said in a statement. "But the improvement in uninsured rates has stalled (and) more people have health plans that fail to adequately protect them from health care costs."
More than half of adults under age 65 are insured through their jobs, while about a quarter are enrolled in Medicaid or have insurance through the individual market, the report said. Among those with health coverage, 29 percent said they were under insured in 2018, up from 23 percent in 2014, the survey found.
In 2018, 41 percent of under insured adults said they had delayed care and 47 percent said they had trouble paying their medical bills. Among those with adequate health coverage, meanwhile, 23 percent said they had put off care, while 25 percent said they had problems with medical expenses.

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