Health gap is seen between insured and uninsured

Government data confirm a significant gap exists in the amount of health care accessed by people who do and do not have health care coverage. Nationally, according to a report that was released by the Robert Wood Johnson Foundation during May's Cover the Uninsured Week, uninsured adults are nearly four times more likely not to see a doctor when they need one, compared to people who have health coverage.

The state-by-state report identifies the extent of disparities in access to health care coverage between insured and uninsured Americans and confirms that not receiving needed care is taking a toll on the millions of Americans who don't have health coverage. Across the nation, it said, a far greater percentage of uninsured adults report being in "poor" or "fair" health, compared to adults with health insurance.

"This report gives a warning to our state and national leaders by showing that our neighbors, friends, and relatives without health coverage live sicker, and will likely die younger, than those who have insurance," said Robert Wood Johnson Foundation CEO Risa Lavizzo-Mourey. "When insured people get sick, they go to the doctor and they get better. When women with insurance are in their 40s, they start getting mammograms regularly. But for people without health coverage, it's a different world. They cannot access basic care or diagnostic screenings because of the cost, so their minor illnesses become major ones. Ultimately, they may require extensive and expensive care because early care was delayed. Our nation's leaders need to realize that this is penny-wise and pound-foolish and finally make health coverage for uninsured Americans their top priority. The alternative is to continue to let the health of millions of our citizens erode and let our health care system creep closer to insolvency."

The report showed that the uninsured not only miss needed medical care due to cost, but they are also far more likely to miss important health screenings that can detect cancer in its earliest, most treatable stages.

Countering the popular opinion that the uninsured are overwhelmingly young and healthy, the analysis showed that an increasing number of Americans older than 50 are finding themselves without health care coverage. According to the most recent figures, about one in six adults ages 50-64 are uninsured, a total of 7 million people, which is an increase of more than 2.6 million over 10 years. Among the report's findings:

  • Uninsured adults are unable to see a doctor and get medical care when needed.
  • Disparities in access exist in every state between insured and uninsured residents.
  • States where the most uninsured adults report not being able to see a doctor when needed due to cost are West Virginia (57%), Oregon (56%), Kentucky (54%), Washington (48%), and Maryland (47%). States where the fewest uninsured adults report not being able to see a doctor when needed due to cost are North Dakota (24%), Montana (32%), Wisconsin (33%), Nebraska (33%), and Massachusetts (34%).
  • Uninsured adults are much less likely to have a personal doctor or health care provider.
  • Nationally, 57% of adults without health coverage say they do not have a personal doctor or health care provider, compared to 16% of people with health coverage.
  • Adults who are uninsured are much more likely to report being in "fair" or "poor" health.
  • Nationally, the percentage of uninsured adults who say their health is fair or poor is nearly twice as high as adults with health coverage (23% vs. 12%).
  • Uninsured adults are less likely to receive screenings to detect cancer than adults with coverage.

Adults with health coverage are far more likely to have received recommended cancer screenings. Women with health coverage ages 40-64, for example, are more than twice as likely to have had a mammogram within the past two years as are uninsured women (51% of insured women vs. 23% of uninsured women). States with the largest percentage of uninsured women not receiving mammograms in the past two years are Missouri (68%), Idaho (66%), North Dakota (64%), Oregon (63%), Utah (61%), and Oklahoma (61%).

The number of Americans older than 50 without health coverage is increasing. The percentage of uninsured Americans ages 50-64 has increased to nearly 15% from about 13% from 1994 to 2004. Although 40% of adults ages 50-64 without health insurance live in the South, the number of uninsured adults older than age 50 in the Midwest is significantly increasing. The Midwest has more than 1.3 million uninsured adults ages 50-64, an increase of nearly 535,000 in 10 years.

Said Former Health and Human Services Secretary Louis Sullivan, "I have worked in health care and health policy long enough to know that usually Congress won't act until the people do. We need millions of Americans to call for change in order to get real action from Washington. Cover the Uninsured Week helps us understand how serious it is to live without health coverage and underscores the terrible consequences this problem puts on families, individuals, employers, and the effectiveness of our health care system. Our leaders need to rise above politics and finally address this long-standing problem."

State-by-state statistics are available at