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31 Million Individuals Underinsured in 2014


Although millions of Americans have gained health insurance under the Affordable Care Act, the Commonwealth Fund recently found that 31 million individuals were underinsured in 2014.

The Affordable Care Act (ACA) may have brought insurance within the reach of millions of Americans, but new data from The Commonwealth Fund revealed that 31 million individuals between the ages of 19 and 64 years were underinsured in 2014. However, because the report surveyed people between July and December 2014, it can not separately assess what effects, if any, the ACA had on underinsurance because people insured all year in the survey had coverage that began prior to the law’s major insurance expansions.

This 23% of Americans were considered underinsured because their out-of-pocket costs and deductibles were too high in comparison to their incomes. The percentage of adults who are underinsured has remained mostly unchanged from 2010 to 2012, but is nearly double that from 2003. In 2003, only 3% of continuously insured adults had high deductibles, but that share has tripled to 11% in 2014.

“The financial and health insecurity that comes from being underinsured is substantial and puts people’s health and well-being at risk,” David Blumenthal, MD, president of The Commonwealth Fund, said in a statement. “If health insurance costs continue to be shifted to consumers at the rates we have seen over the past 10 years, the problem will likely grow.”

Nearly half (44%) of underinsured adults reported that they did not get the care they needed because of cost. Half of underinsured adults and 41% of privately insured adults who were paying off medical bills had debt loads of at least $4000.

Medicaid beneficiaries under the age of 65 who were disabled were underinsured at the highest rate and people with health problems were most likely to be underinsured. Compared with just 16% of healthier individuals, 30% of people who in poor health or who had chronic health problems or disability were underinsured.

“People with health insurance should be able to get the health care they need without depleting their savings accounts or worrying about potential bankruptcy,” said Sara Collins, vice president for Health Care Coverage and Access at The Commonwealth Fund and the report’s lead author. “Changing the way we design health insurance benefits to keep rising deductibles in check could help keep health care affordable.”

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