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Study: 'Underinsured' Adults Compound Uninsured Problem

JUNE 14, 2005 -- Millions of Americans have health insurance that does not adequately protect them against catastrophic health care expenses, according to a study released Tuesday by the Commonwealth Fund, which studies health and social issues.

In addition to the 45 million uninsured adults in the United States, another 16 million were "underinsured" in 2003, according to the study published in the journal Health Affairs. An estimated total of 61 million adults, or 35 percent of individuals ages 19 to 64, had either no insurance, sporadic coverage, or insurance that exposed them to high health care costs during 2003, Commonwealth officials said in a news release.

Underinsured adults are almost as likely as the uninsured to go without needed medical care and to incur medical debt, the authors found. Lower-income and sicker adults are also more at risk of having inadequate coverage.

The study defined an underinsured person as one who has insurance and spends between 5 percent and 10 percent of their income on health care.

The study's authors warn that recent market trends will likely place increasing numbers of insured patients and their families at risk due to higher cost-sharing and out-of-pocket exposure. An increase in the number of underinsured could undermine effective care, health, and financial security, making it harder to distinguish the uninsured from the insured, the authors note.

Individuals without adequate health insurance were significantly more likely to go without care because of the cost. More than one-half of both the underinsured and the uninsured went without needed care during the year, such as failing to fill a prescription, skipping a test or follow-up visit, failing to visit a doctor for a medical problem, or not receiving specialist care.

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