Healthcare reform: The Uninsured

As insurance premiums rise and more employers drop coverage, an increasing number of Americans are living without health insurance. Nearly one in three non-elderly Americans—86.7 million people—went without health coverage for all or part of 2006-2007.

And four out of five of those individuals were in working families.

Why does insurance matter? People without insurance are more likely to go without preventive care, to delay or forgo medical care, and to die prematurely. When sick, the uninsured may turn to emergency rooms for care, where oftentimes they are charged more for services than insured patients. And when uninsured patients can’t afford their medical bills, the cost of this care is passed on to the insured in the form of higher premiums.

The number of uninsured Americans reached an all-time high in 2010, as nearly 50 million Americans went without health insurance for the entire year. For many of these uninsured people, the consequences of going without coverage are dire. The uninsured frequently face medical debt or go without necessary care, and too many of them die prematurely.

While it is true that hospitals cannot turn away anyone, it is also true that those individuals will end up with enormous hospital bills. Some will file bankruptcy when it becomes too much of a burden to pay these bills; some will spend their lifetime paying the bill a few dollars a month; others will just walk away from it – unable to pay the bill, and unwilling to face the shame of asking for help.

In 2002, the Institute of Medicine released a groundbreaking report, Care without Coverage: Too Little, Too Late. This report estimated that, nationwide, 18,000 adults between the ages of 25 and 64 died in 2000 because they did not have health insurance.  Since then, the crisis of the uninsured has grown even larger. During the economic downturn, millions of Americans lost both their jobs and their health coverage, and rising health insurance premiums have priced many more out of coverage.

Thankfully, the new health care law can help stem the rising tide of the uninsured. Beginning in 2014, millions of Americans will be eligible for assistance with the cost of health coverage. In addition, insurance companies will no longer be able to deny coverage or charge higher premiums to people with pre-existing conditions. These measures, among others, will help reverse the growth in the number of uninsured Americans year after year.