25 Million American Adults Are Underinsured, Report Finds

The number of underinsured American adults — those with health insurance but high medical expenses relative to their incomes — rose 60 percent between 2003 and 2007, a new report from the Commonwealth Fund finds.

The report, How Many Are Uninsured? Trends Among U.S. Adults, 2003 and 2007 (summary, 2 pages, PDF), found that the number of uninsured adults increased from 16 million in 2003 to 25 million in 2007. Middle and higher-income families were hit hardest by the increase; underinsured rates nearly tripled for those with incomes above 200 percent of the federal poverty line (i.e., annual family income of $40,000 or higher). Underinsured rates are now at double-digit levels for families with household income in the 200-400 percent of poverty range, which is considered to be solidly middle class.

Including those who were without insurance for any time during the year, the study found that an estimated 42 percent of adults between the ages of 19 and 64 (75 million people) were either uninsured or underinsured as of 2007 — up from 33 percent in 2003. The report's authors conclude that in order to achieve quality care and better health outcomes, benefits should be designed with an eye to reducing cost-sharing for families with low and modest incomes.

"The United States needs to move in new directions," said Commonwealth Fund president Karen Davis. "Middle- and low-income families are struggling through tough economic times and we need to extend affordable, effective health insurance to all. Shifting costs to patients is not an equitable or effective solution to rising costs. It's time for serious consideration of changes in the way we pay for and deliver health services — reforms that show much greater potential for gains in quality and efficiency."

"Insured but Poorly Protected: 25 Million Adults Are Underinsured." Commonwealth Fund Press Release 06/10/2008.