Researchers Map Individual Health Coverage Gaps

Only 14% of the survey participants with incomes over 200% of the federal poverty level who had considered getting individual health coverage had actually bought coverage, the researchers report.

About 29% of the participants with solid incomes who had shopped for individual coverage said it was difficult to find the coverage they needed, 50% had located coverage but felt that it was too expensive, and 18% were turned down or charged a higher price for coverage because of a pre-existing medical condition, the researchers report.

Insurers rejected or offered higher than usual rates to about 21% of all survey participants who have applied for individual coverage, the researchers report.

When the researchers asked about preventive care, they found that 89% of the individual policyholders had their blood pressure checked within the past year, 75% had their cholesterol levels checked, and 67% had dental exams.

About 93% of members of group plans had had their blood pressure checked, 78% had undergone cholesterol screening, and 73% had had dental exams, the researchers report.

The researchers also found that individual policyholders were more likely than group plan members to take on credit card debt to pay for care.

America’s Health Insurance Plans, Washington, is disputing the Commonwealth Fund researchers’ assertions that applicants for individual health coverage face a high rejection rate.

A survey of AHIP member companies found that, even in states that allow individual underwriting, the individual health insurance applicant rejection rate is only slightly over 10%, AHIP says.

The Commonwealth Fund rejection rate figure may be high because the group’s survey sample includes only 137 individuals who now own individual health coverage, AHIP says.