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Pizer SD (VA Boston Healthcare System), Frakt AB
(VA Boston Healthcare System), Iezzoni LI
(Harvard Medical School)
Objectives:
This study quantified the rate of uninsurance among non-elderly veterans and how the rate varies over time, geography, and for key vulnerable subpopulations: those with serious health conditions or functional impairments, and those with low incomes.
Methods:
We conducted descriptive analyses using multiple years (2000-2005) of the Medical Expenditure Panel Survey (MEPS). We tabulated rates of uninsurance stratified by one or several of the following: year, US region, presence of serious health condition, level of functional status, income level, and labor force participation.
Results:
Analyses to date have shown that among non-elderly adult US residents, the risk of being uninsured increased from 2000 to 2005 and varied widely across subpopulations defined by income, health status, and geography. Over all regions and years, uninsurance rates were particularly high for low-income workers reporting potentially serious health conditions (32%) or disabilities (24%). Rates were highest in the South (42% for persons with health conditions; 39% for persons with disabilities) and West (27% health conditions; 21% disability).
Implications:
Overall, our findings indicate that it is not uncommon for non-elderly US residents with disabilities and/or significant health conditions to lack health insurance, especially in the South and West. It appears that state-by-state differences in Medicaid eligibility rules allow substantial numbers of these individuals to fall through the “safety net” by design.
Impacts:
The uninsured individuals identified by this study face substantial health risks because of their lack of insurance. The VA’s role as a “safety net” provider of healthcare services may grow as rates of uninsurance continue to increase. This is especially true in certain regions (the South and West) and for certain subpopulations that fall through the cracks of other public programs (Medicare and Medicaid).
