WASHINGTON – People living on incomes below 250 percent of the poverty rate – less than $55,875 per year for a family of four – have a disproportionately high rate of uninsurance and access to healthcare, according to a new report released yesterday by the Commonwealth Fund.
The survey, The Income Divide in Health Care: How the Affordable Care Act Will Help Restore Fairness to the U.S. Health System, is the first of a series of annual reports to be produced by the Commonwealth Fund as it looks to track the affects of the Patient Protection and Affordable Care Act.
Specifically, the researchers found that 57 percent of people in low-income families – those earning less than $29,726 for a family of four (133 percent of poverty) – were uninsured for some time in the past year, and 35 percent had been uninsured for two years or more. Thirty-six percent of adults in moderate-income families – those earning between $29,726 and $55,875 for a family of four (133 to 249 percent of
poverty) – were uninsured during the year, and 18 percent had been uninsured for two years or more.
In contrast to these high rates of uninsurance, families living on incomes of 400 percent of the poverty level and higher – more than 89,400 per year for a family of four – had only 12 percent of adults who reported being uninsured at any point during the past year and only 4 percent had been without insurance for more than one year.
“The report is especially important, as we face a growing income divide in our country,” noted Karen Davis, president of the Commonwealth Fund in a press briefing. “High healthcare costs, unstable coverage and difficulty getting preventive healthcare undermine not only the current health and financial security of families, but can potentially affect financial mobility over a lifetime.”
Lack of insurance was also tied to lower overall rates among adults who have received preventive healthcare. Just 10 percent of low-income uninsured adults age 50 and over had received the recommended screening for colon cancer, compared with 50 percent of those in the same income range who had health insurance, and 56 percent of higher-income adults. Only about one-third (32 percent) of low-income uninsured women ages 40 to 64 had received a mammogram, compared with two-thirds (66 percent) of low-income women with health insurance, and three-fourths (74 percent) of higher-income women.
“People with low and moderate incomes run the highest risk of lacking job-based health insurance, are least able to afford health insurance on their own, and are the most at risk of not being able to afford care in the absence of coverage,” said Sara Collins, vice president of the Commonwealth Fund and lead author of the report. “Consequently, problems getting needed care in the United States are disproportionately concentrated among low- and moderate-income families.”
While the report paints a dire snapshot of the current state of the uninsured in the country, it also notes that many of the provisions within PPACA are set to alleviate many of these disparities.
Some of those changes are already being felt Davis noted, pointing to the expansion of coverage affordable to young adults who can now stay on their family’s employer provider health insurance plans until the age of 26. Davis also touted the expansion of Medicaid and the Children’s Health Insurance Plan (CHIP) as providing a safety net of healthcare coverage to the lowest income populations in the country.
Finally, the introduction of the individual mandate for health insurance and the coming state health insurance exchanges in 2014 will expand the number of people with health insurance from between 34 million and 40 million by 2020.
