Health consequences of uninsured adults: An updated review

Abstract

The health consequences of uninsurance are real, vary in magnitude in a clinically consistent manner. Health services research conducted over the past 25 years makes a compelling case that having health insurance or using more medical care would improve the health of the uninsured. Uninsured adults have less access to recommended care, receive poorer quality of care, and experience worse health outcomes than insured adults do. Uninsured adults forego preventive care and seek health care at more advanced stages of disease. Society then bears these costs through lower productivity, increased rates of communicable diseases, and higher insurance premiums. Some mortality studies imply that a 4%–5% reduction in the uninsured's mortality is a lower bound; other studies suggest that the reductions could be as high as 20%–25%. The potential health benefits of expanding insurance coverage for these adults may provide a strong rationale for reform. In its review study, we have highlighted the health consequences of uninsurance among adults.