Publications: Health Insurance

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From Coast to Coast: The Affordability Crisis in U.S. Health Care

March 1, 2004 - More than two of five Midwestern adults say they had problems with their medical bills or were paying off accrued medical debt, says a Commonwealth Fund report. Nearly a quarter of Midwesterners said they had difficulty paying or were unable to pay medical bills.

Issue Brief

Front and Center: Ensuring that Health Reform Puts People First

June 11, 2009 - This report focuses on those who would benefit from such health reforms, including the estimated 116 million working-age adults, or two-thirds of all adults, who report that they are uninsured or underinsured, have medical bill or debt problems, or experience difficulties obtaining needed care.

Fund Report

Full Coverage for Preventive Medications After Myocardial Infarction

November 21, 2011 - Patients discharged from the hospital after heart attack were more likely to take medications prescribed for their condition when copayments were eliminated, a Commonwealth Fund–supported study concludes. Patients with full coverage also experienced fewer heart attacks, strokes, and other vascular events during the study period—and total spending by the insurer did not change.

In the Literature

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

August 1, 2001 - The authors examine health coverage and access to care among working-age adults using the Kaiser/Commonwealth 1997 National Survey of Health Insurance, and report that having even a temporary gap in health coverage made a significant difference in access to care for working-age adults.

In the Literature

Gaps in Health Insurance: An All-American Problem

April 26, 2006 - America's uninsured crisis disproportionately affects lower-income working families. But new survey data show that moderate-income Americans are increasingly going without health coverage as well.

Fund Report

Gaps in Health Insurance: Why So Many Americans Experience Breaks in Coverage and How the Affordable Care Act Will Help

April 19, 2012 - One-quarter of adults ages 19 to 64 experienced a gap in their health insurance in 2011, with a majority remaining uninsured for one year or more, according to the The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults.

Issue Brief

Getting and Keeping Coverage: States' Experience with Citizenship Documentation Rules

January 12, 2009 - A new Commonwealth Fund report examines the impact recent citizenship documentation rules have had on the stability of health insurance coverage for low-income children covered by state public programs. It finds that getting and keeping coverage has become more difficult for many families.

Fund Report

Group Insurance: A Better Deal for Most People Than Individual Plans

December 3, 2009 - In this Fund-supported Health Affairs study, employer-sponsored health plans were found to be much more affordable, and to offer more comprehensive coverage, than individual market plans. Deductibles average more than $2,100 for individual plans but less than $600 for employer-based plans, the researchers say.

In the Literature

The Growing Financial Burden of Health Care: National and State Trends, 2001-2006

March 25, 2010 - The percentage of Americans facing high out-of-pocket health care expenses and insurance premiums continues to increase. In all income brackets, people with private insurance experienced an increase in their health care–related financial burden between 2004 and 2006, with the greatest increase occurring among middle- and higher-income individuals.

In the Literature

The Growing Share of Uninsured Workers Employed by Large Firms

October 10, 2003 - Although large employers are much more likely than small ones to offer health coverage, recent evidence suggests that large-firm workers and their dependents comprise a significant and growing share of the working uninsured.

Fund Report

Has the Time Come for Cost-Effectiveness Analysis in U.S. Health Care?

July 17, 2009 - Three-quarters of key decision-makers from a diverse group of California-based health care organizations believe that cost-effectiveness criteria should be used when making insurance coverage decisions, according to this Commonwealth Fund-supported study. However, payers and the legal and policy communities would need to explore ways of reducing the litigation risk associated with cost-effectiveness analysis, the authors say.

In the Literature

Health and Productivity Among U.S. Workers

August 31, 2005 - Health problems among working-age Americans and their families cost an estimated $260 billion in lost productivity each year, a new Fund study finds. This "lost labor time" results from health problems that make it difficult to hold jobs, missed work days, and an inability to concentrate at work because of sickness or related worries.

Issue Brief

Health Care Costs and Instability of Insurance: Impact on Patients' Experiences with Care and Medical Bills

June 28, 2004 - Recent reports of hospitals billing uninsured patients at higher rates than insured patients and using aggressive collection practices are symptoms of two underlying trends in the U.S. health care system—growing instability in insurance coverage and rapid growth in the cost of care, Fund senior program officer Sara R. Collins, Ph.D., told a congressional hearing in invited testimony.


Health Care Disconnect: Gaps in Coverage and Care for Minority Adults: Findings from the Commonwealth Fund Biennial Health Insurance Survey (2005)

August 1, 2006 - Uninsured rates for Hispanic and African American adults are up to three times greater than the rate for white adults, according to new analysis of the Fund's Biennial Health Insurance Survey.

Issue Brief

Health Care in the 2012 Presidential Election: How the Obama and Romney Plans Stack Up

October 2, 2012 - With President Obama and Governor Romney offering fundamentally different visions for the nation's health system, the presidential election provides a stark choice for U.S. voters. This analysis contrasts the potential impact of implementing the Affordable Care Act in full with Romney’s proposals to repeal the law, eliminate many of the new requirements for insurance markets, and make changes in Medicaid and Medicare.

Fund Report