26% Had Health Insurance Gap In 2011, Study Finds

By: CNN Posted By: Stephanie Schultz
By: CNN Posted By: Stephanie Schultz
The fate of health care reform legislation is still up in the air, resting with the U.S. Supreme Court, which is expected to rule on the law


(CNN) -- The fate of health care reform legislation is still up in the air, resting with the U.S. Supreme Court, which is expected to rule on the law's constitutionality in late June.

But today's news about health insurance isn't about the justices; it's about the people who had gaps in coverage in 2011.

The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults found that 26% of Americans had a hole in their health insurance coverage in 2011. That would equate to about 48 million people who were uninsured at some point during the year, the Commonwealth Fund said.

Losses or changes in jobs, either on the part of the individual or his or her spouse, were driving factors in many cases. The survey was administered by The Commonwealth Fund, a nonprofit organization headquartered in New York.

"It's a difficult place to find an affordable plan, and it's also a difficult place to comparison-shop," said Sara Collins, vice president for the Affordable Health Insurance Program at The Commonwealth Fund. "There just isn't a lot of information tools to help people in their search for a plan."

The survey included 2,100 adults in the United States ages 19 to 64.

Of those who reported a gap in health insurance, 69% said they did not have insurance for a year or longer, and 57% went two or more years without coverage.

The survey found that nearly half who tried to get coverage over the past three years did not end up buying a plan on the individual market. The majority of them, 62%, said the premiums were too expensive.

It proved difficult to compare benefits that different plans offer for 60% of respondents who tried to purchase a plan. And almost one-third of participants said insurance plans turned them down, raised prices or excluded a condition because of a pre-existing condition.

Participants also appeared less likely to have a regular doctor and get preventative tests such as blood pressure and cholesterol monitoring if they had a gap in health insurance.

The Commonwealth Fund had said in a report last year that about 9 million people who lost a job with health benefits in 2008 to 2010 became uninsured, indicating that employment is tied to health coverage for many Americans.

The Supreme Court will make a decision about the constitutionality of the Affordable Care Act, which includes a mandate for all Americans to purchase health insurance.

If the Affordable Care Act stays in place, in 2014 insurance plans would not be allowed to charge higher premiums or drop people because of pre-existing conditions or health status.

Also, in 2014, insurance exchanges would be available in every state, where people who lose employer-based coverage can find coverage. Those with a household income of up to 400% of the poverty line (about $88,000 for a family of four) would be eligible for tax credits, and Medicaid would be expanded to people with incomes of up to 133% of poverty level (about $30,000 for a family of four).

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