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More Americans Experiencing Gaps in Health Coverage
Date:4/22/2009

lot since then," noted Carol Pryor, policy director at the Access Project, a nonprofit health advocacy group in Boston. "I imagine that they've gotten worse."

Using Census Bureau data, Cutler found the incidence of coverage gaps has been rising over time. The percentage of people who lost coverage in a 12-month period rose to 21.8 percent in the 2001 to 2004 time period from 19.8 percent in the earlier span.

People with the lowest educational level -- no high school diploma or equivalency (GED) -- appear to be especially vulnerable. Their likelihood of losing health insurance rose to 40.3 percent in the 2001 to 2004 period, an increase of 8.3 percentage points from the earlier period. In the latter period, only 10.2 percent of people with at least a college degree were likely to lose coverage, an increase of 0.3 percentage points from the earlier years.

Among people in fair or poor health, the probability of losing coverage rose 11.2 percentage points between the two survey periods, to 30.5 percent. That compares with an increase of just 3.3 percentage points, to 17.7 percent, among those who said they were in excellent, very good or good health.

However, uninsured periods grew shorter. The percentage of people who were uninsured for two or more years, for example, declined to 20.3 percent in the latter period, a 5.9 percentage-point improvement. Cutler noted that the shorter uninsured periods are not surprising given the enormous increase in Medicaid coverage that has occurred over time.

Chances of being uninsured and landing private insurance within two years dropped 6 percentage points between the two survey periods.

Cutler said that policymakers need to act now to ensure that coverage is expanded to everyone and that people who lose insurance don't have to rely on a patchwork of public programs. He predicted serious problems ahead if more people lose employer-based coverage.

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