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05-06-2012 | Article

One in 10 nonelderly US veterans do not have medical insurance

Abstract

Full report (pdf)

MedWire News: One in 10 nonelderly US veterans do not have medical insurance and do not use healthcare services provided by the Department of Veterans Affairs (VA), reveal data from the 2010 American Community Survey (ACS), issued by the Urban Institute and released by the Robert Wood Johnson Foundation.

The 2010 ACS sampled over 129,000 nonelderly veterans, identified as those aged 19 to 64 years who had ever served on active duty but are no longer serving. The Urban Institute examined rates of uninsurance among these veterans and their families at both the national and state levels and their access to care, among other parameters.

The uninsurance rate among the veterans surveyed was 10.5%, considerably less than the 17.9% uninsurance rate among the general nonelderly US population. Rates varied significantly across states, from a low of 4.3% in Massachusetts to a high of 17.3% in Montana.

Compared with their insured counterparts, uninsured veterans are younger, have lower formal education levels, are more likely to be unemployed or working part-time, and are less likely to report any service-related disabilities.

The survey found that 41.2% of uninsured veterans have unmet medical needs and 39.5% have unmet dental needs, with over a third reporting delaying care due to healthcare costs. About 55% of uninsured family members also reported unmet medical needs.

Based on the expanded income range under the 2010 Affordable Care Act (ACA), almost 50% of uninsured veterans would qualify for Medicaid. This could provide, the Institute notes, "new routes to health insurance coverage for veterans and their family members." Currently, only about 10% are Medicaid-eligible. However, this change will not address uninsured veterans' unmet dental needs, as dental coverage is not part of the ACA.

The Institute adds that "additional interventions may be needed in order to address access gaps." These gaps include specialized needs or diverse attitudes towards having any health insurance coverage. Also, patients who have VA coverage also use non-VA services, which can lead to fragmented care. As the survey report notes, "when increased coverage options become available under the ACA, targeted assistance to veterans using the VA system may be needed to help them make informed choices that do not disrupt the care they have been receiving."

The consensus of the Institute report is that improving access to healthcare services for uninsured veterans and their family will depend on timely enrollment in coverage when the ACA takes effect. "The extent to which the ACA can achieve dramatic reductions in uninsurance among veterans and their families will depend on aggressive ACA implementation and outreach efforts nationwide," it states.

By Stephanie Leveene