September 15, 2011—As many as 81 million American adults lack health insurance or have inadequate coverage that leave them exposed to unaffordable medical costs, new studies by the U.S. Census Bureau and the Commonwealth Fund indicate.
In its annual report on poverty in the United States, released on Sept. 13, the Census Bureau found that there were 49.9 million Americans of all ages without health insurance in 2010, up from 49.0 million in 2009. Of those, 7.3 million were children.
In a separate Sept. 8 study, the Commonwealth Fund reported that the number of underinsured Americans 18 and older rose by 80 percent between 2003 and 2010, from 16 million to 29 million. The think tank defined being underinsured as having out-of-pocket costs exceeding 10 percent of income or having medical expenses or per-person deductibles exceeding 5 percent of income.
The Census Bureau said the percentage of Americans living in poverty in 2010—15.1 percent—rose to the highest level since 1993. The percentage of people with private health insurance declined from 64.5 percent to 64.0 percent, it said, while the percentage of those with government health insurance rose from 30.6 percent to 31.0 percent.
According to the Commonwealth Fund, rates of foregone care, such as not having a prescription filled, were twice as high among the underinsured and three times as high among the uninsured as rates reported by adults with more adequate insurance.
Families with low incomes were the most vulnerable, it said, with 77 percent of those with incomes 133 percent below the poverty level either uninsured or underinsured, as were 58 percent of those with incomes between 133 percent and 250 percent of the poverty level.
The Commonwealth Fund also found that the risk of being underinsured is rising up the income scale. In 2010, 16 percent of adults with incomes between $40,000 and $60,000 were underinsured, compared with only 5 percent in 2003.
The group said that provisions in the Affordable Care Act to extend health care coverage to more people could reduce the number of underinsured people by 70 percent by the time the law is fully implemented in 2014.