Lack of Health Care Coverage Affects The Insured and the Uninsured Alike

By: Gresenz CR and Escarce JJ

In: Medical Care, 49(9), pp.e14-e21

Publisher: Lippincott Williams & Wilkins

Published: September 2011

A high community uninsurance rate may affect access to and quality of care by restricting provision of unprofitable services, shortening hours, and providing lower quality of care to all patients, whether insured or uninsured.

This article explores the indirect, or spillover, health care effects on people who are currently insured, specifically privately insured working-age adults (18 to 64) and Medicare enrollees (65 and older), when the community uninsurance rate is high.

Using data from the 1996 through 2006 Medical Expenditure Panel Survey (MEPS) Household Component, the study considers whether a person has a usual source of care, the use of office visits, and the satisfaction with usual provider and overall health care. Data from 200 metropolitan areas in the United States over the preceding 12 months were used to analyze two samples totaling 86,928 insured adults.
Key Findings:

• Working-age adults with private insurance residing in areas with a high rate of uninsurance were less likely than their peer in areas with a low rate of uninsurance to have a usual source of care, an office-based visit, and any medical care expenditures.
• Seniors with Medicare coverage were more likely than their counterparts to report difficulty getting the care and prescription drugs needed.

The authors note that across a wide range of measures, an adverse effect of high community uninsurance is access to and satisfaction with health care for those who are insured.

Get full text or downloads

• Spillover Effects of Community Uninsurance on Working-Age Adults and Seniors - Executive Summary
• Spillover Effects of Community Uninsurance on Working-age Adults and Seniors - Full Text