Even short health coverage disruptions can have negative impact on health
Among adults with current private or current public coverage, disruptions were associated with lower receipt of all preventive services.
Many U.S. workers have experienced disruptions in health insurance coverage during the economic slowdown caused by the pandemic. Coverage disruptions are especially common among the poor and those with Medicaid coverage.
Even brief coverage disruptions can have a significant impact on health, according to a new study reported in the “American Journal of Preventive Medicine.” Earlier studies found that a single loss of coverage of one month or more was associated with being less likely to have a usual place for care, having worse access to care, more emergency department use and declines in overall health.
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The recent study found that:
- Overall, 5% of currently insured adults with private and 11& with public insurance reported a coverage disruption in the previous year, representing nearly 9.1 million adults in 2018.
- Among those currently uninsured, 25% reported coverage loss within the previous year, representing nearly 8.1 million adults in 2018.
- Among adults with current private or current public coverage, disruptions were associated with lower receipt of all preventive services; with forgoing any needed care because of cost; and with medication nonadherence because of cost, compared with adults with continuous coverage.
- Longer disruptions among currently insured adults were significantly associated with worse care access, receipt and affordability, with dose–response patterns.
- Currently uninsured adults, especially those with longer uninsured periods, reported significantly worse care access, receipt and affordability than currently insured adults with coverage disruptions or continuous coverage.
Understanding the associations of insurance coverage disruptions with access and affordability is especially relevant with recent increases in unemployment because of the pandemic and widespread loss of employer-based private coverage, the primary source of private coverage in the working-age population.
“This study found strong, consistent associations of coverage disruptions with access to and receipt of preventive care and affordability across multiple measures among adults aged 18 to 64 years in the United States,” researchers concluded. “These findings are especially relevant with the widespread unemployment and loss of employer-based health insurance coverage as part of the effects of COVID-19 pandemic. Longitudinal studies evaluating the effects of coverage disruptions on care access, receipt, affordability and health outcomes will be important to inform the development of future health insurance policies.”
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