Entrances and Exits: Health Insurance Churning, 1998-2000
By Kathryn Klein, Sherry Glied, and Danielle Ferry
The Commonwealth Fund
September 2005
Abstract:
Analysis of 1998-2000 health insurance data from the Medical Expenditure Panel Survey shows large numbers of people with unstable health insurance coverage.Young adults, Hispanics, people with low levels of education, those who transition into and out of poverty, and those with private non-group insurance are most likely to have unstable coverage. In addition, demographic factors and type of insurance interact to determine stability of coverage.Young adults and Hispanics with Medicaid or private insurance, for example, were relatively likely to lose their coverage. And less than half of people who transitioned into and out of low income and were initially uninsured were able to obtain coverage. Policies must target these high-risk groups in order to provide them with stable health insurance coverage.
http://www.cmwf.org/usr_doc/klein_855_entrancesexits_ib.pdf
Comment: Numerous studies have shown that individuals with unstable, intermittent insurance coverage are exposed to the same risks as the uninsured: financial hardship, impaired health outcomes, and even death. Policies should target not only the uninsured, but the victims of insurance churning as well. Targeting policies to the latter can be difficult since these are moving targets.
Obviously insurance churning would disappear, as would the problems of the uninsured and the under-insured, if we adopted a universal, single payer system. It is astounding that we continue to reject a simple, affordable, highly effective solution, while we continue to tinker with more carefully targeted but fragmented programs that are more expensive and relatively ineffective. Whatever happened to common sense?