Catherine Hoffman

Gaining and losing health insurance: strengthening the evidence for effects on access to care and health outcomes.

This study uses longitudinal data to examine the consequences of losing and gaining health insurance coverage for access to care and health. For both Medicaid and privately insured persons, compared with those who remained insured, persons losing coverage over a 2-year period were more likely to lack a usual source of care, encounter difficulty in obtaining medical care, be very dissatisfied with ability to obtain needed care, and report no physician visits in the previous 12 months. Uninsured people who gained coverage showed improvement across all indicators of access, in contrast to those who remained without insurance. The effects of changes in coverage on health were in the same direction as those for access, but did not reach statistical significance. This study strengthens the evidence that health insurance coverage has a substantial impact on ability to gain access to medical care and may affect health status.

Eroding Access Among Nonelderly U.S. Adults With Chronic Conditions: Ten Years Of Change

Both the connection to health care and its affordability worsened for many nonelderly U.S. adults living with chronic conditions between 1997 and 2006. This erosion varied by health insurance coverage, fundamental as it is to securing health services. Access to care among uninsured adults with chronic conditions deteriorated on all of our basic measures between 1997 and 2006. In addition, more of both the privately and publicly insured with chronic conditions went without health care because of its cost over this ten-year span, even while they were just as likely as or more likely than others to have a usual source of care over time.

Gaps in Health Coverage Among Working-Age Americans and the Consequences

This paper examines health coverage and access to care among working-age adults using the Kaiser/Commonwealth 1997 National Survey of Health Insurance. One in three (52 million) working-age adults were either uninsured at the time of the survey or had a recent gap in their health coverage in the past two years. Having even a temporary gap in health coverage made a significant difference in access to care. Compared to the elderly, who are continuously covered by Medicare, working-age adults have greater problems paying their medical bills and gaining access to care and are less satisfied with their health insurance coverage.

Holes In The Health Insurance System-Who Lacks Coverage And Why

Catherine Ho&an Diane Rowland Alicia L. Carbaugh ack of health insurance coverage is a large and growing problem for millions of American families. Rising health care costs L and economic insecurity continue to threaten the bedrock of the health insurance system employer-sponsored coverage while states’ fiscal situations and the escalating federal deficit complicate any efforts at reform. Providing health insurance coverage to the millions of uninsured remains a major health care challenge for the nation and understanding the current health insurance environment, who the uninsured are, and why they are uninsured is critical when considering health care reform. This paper aims to define the problem of the uninsured, providing an overview of the uninsured in America and the roles and l i i i ts of private and public insurance. Following this discussion, the paper describes the current health insurance environment and examines the prospects for improving coverage.