Group Title: Florida Health Insurance Study fact sheets
Title: Gaps in coverage: uninsured part of the year
ALL VOLUMES CITATION PDF VIEWER THUMBNAILS PAGE IMAGE ZOOMABLE
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/UF00091096/00003
 Material Information
Title: Gaps in coverage: uninsured part of the year
Series Title: Florida Health Insurance Study fact sheets
Physical Description: Serial
Language: English
Creator: Florida Center for Medicaid and the Uninsured, College of Public Health and Health Professions, University of Florida
Publisher: Florida Center for Medicaid and the Uninsured, College of Public Health and Health Professions, University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: September 2005
 Record Information
Bibliographic ID: UF00091096
Volume ID: VID00003
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.

Downloads

This item has the following downloads:

fs03-09-2005-CoverageGaps-UninsuredPartOfYear ( PDF )


Full Text





FHISu
Florida Health Insurance Study


Fac She No. 3~ Setmer20


Gaps in Coverage: Uninsured Part of the Year

According to the Florida Health Insurance Study 2004 (FHIS 2004), about 19.2%
of non-elderly Floridians were without health insurance at the time of the survey
interview. But another important statistic is the number and percent of Floridians
who experience gaps in their health insurance coverage those who were
uninsured for part of the previous year.
Breaks in continuous health insurance coverage can intensify problems of access
to health care and difficulties paying medical bills, and may lead to negative
health consequences. Indeed, a recent article in the New England Journal of
Medicine indicates that having gaps in health insurance coverage can be almost
as bad as having no coverage at all when it comes to obtaining preventive
health care in a timely fashion. More complete knowledge of gaps in health care
coverage is an important step to fully understanding the scope of the health
insurance problem.
This fact sheet, using data from the FHIS 2004, examines differences among
Floridians who were continuously covered by health insurance during the past
year, those who were insured at the time of the survey but experienced an
episode of uninsurance in the past year, and those who were uninsured the entire
year.
Who has gaps?
A substantial number of Floridians experience gaps in health insurance coverage.
About 75.3% of non-elderly Florida residents were insured the entire year, while
14.0% were uninsured the entire year, and 10.8% were uninsured for part of the
year (Figure 1). More than half of those who experienced gaps in coverage had
gone without coverage for six months or less (60.1%), while more than a third
(39.9%) had been without coverage for seven to 12 months.
I Fiur 1: Gap in C ovea e Flrdin Un e Ag 65,- 2004


Uninsured All

4.0% Uninsured 6
Months or less
60.1%
Uninsured 60
Part of Year
10.8%
UUninsured
7-11 Months
39.9%


Source: 2004 Florida Health Insurance Study (FHIS)






Duration of Uninsurance
Among those individuals who lacked A
insurance coverage for at least part 1 month
of the year, 42.7% had been without or less
Never
coverage for more than a year, and had insurance 4.1%
another 15.0% had never been insured. 15.0%
A quarter (25.4%) had been without
coverage for six months or less. The 1-6 months
remainder lacked coverage for six- 21.3%


Demographic Breakdown
In Florida, adults and children are More than
equally likely to experience gaps in 2 years
health insurance coverage. FHIS 2004 28.1%
data indicate that 10.9% of children 16.9%
and 10.7% of adult Floridians were
uninsured for part of the year in 2004.
However, the rates of continuous 1-2 years
health insurance coverage are higher Source: 2004FloridaHealth InsuranceStudy (FHIS) 14.6%
for children (81.9%) than for adults
(72.4%). This outcome reinforces the findings of Fact Sheet No. 2 'Health Insurance Coverage Among Children in
Florida' that the State's aggressive implementation of children's healthcare programs results in increased levels of
uninterrupted health insurance coverage for children.


Percent (%)



Ages 0 64 75.3 10.8 14.0
Ages 0 18 81.9 10.9 7.2
A es 19 64 72.4 10.7 16.9
White Non-Hispanic 80.6 10.0 9.4
Hispanic 61.3 13.5 25.3
Black 72.1 12.4 15.6
Other 74.0 11.5 14.5
Less than/= 100% FPL 54.6 16.5 28.9
101 150% FPL 53.9 18.6 27.5
151 200% FPL 65.7 13.6 20.7
201 250% FPL 69.4 17.2 13.4
251% FPL or greater 87.3 7.2 5.6
Souce 200 Floid Helt Inuac- tuy(


There are notable
differences in coverage
among racial and ethnic
groups. White Non-
Hispanics are the least likely
to experience gaps in health
care coverage (10.0%),
and are the most likely to
be continuously covered by
health insurance (80.5%).

Gaps in coverage are
experienced by 13.5% of
Hispanics and 12.4% of
Blacks. Both groups have
lower rates of continuous
health insurance coverage,
suggesting that they have
problems both obtaining and
maintaining health insurance
coverage.


Even more striking than differences among racial/ethnic groups are the differences among income groups. Low-
income people, especially those with family income at or below 150% of the Federal Poverty Level (FPL), are
much more likely to have experienced gaps in health insurance coverage. Low-income families are also more
likely to have experienced long-term uninsurance (being uninsured for more than one year). Only 7.2% of those
with incomes greater than 250% of the FPL reported having gaps in insurance coverage, and only 5.6% were
uninsured for the entire year.


FLORIDA HEALTH INSURANCE STUDY


page 2







Employment and Gaps in Coverage
Continuity of coverage also varies
substantially by employment status (Figure
3). Unemployed workers had the highest
rate of gaps in coverage (23.0%) of any
employment group, a rate much higher than
the group with the next highest rate, those
who are not in the workforce (15.2%). Full-
time workers were less likely to report gaps
in coverage (8.8%) than other employment
groups.

The unemployed are particularly
disadvantaged-not only are they likely to be
uninsured for part of the year, but they are
also the most likely to have been uninsured
the entire year (34.7%).

Gaps in Coverage and Access to
Care
People who experience gaps in insurance
coverage are more likely to experience
problems obtaining appropriate health care.

Overall, 22.4% of respondents did not
have a usual source of care. However,
there are observable differences in having
a usual source of care depending on the
individual's insurance status. Only 16.0%
of the continuously insured reported being
without a usual source of care, compared
with 36.7% of continuously uninsured
respondents and 45.2% of respondents
with gaps in coverage. People with gaps in
coverage and those with no coverage report
not having a usual source of care more often
than those who are continuously insured;
they also report delaying needed medical
care because they could not afford it.


F I u Insured All Year a Uninsured Part of Year m Uninsured All Year


100%
90% -
80%
70%
60%
50%
40%
30%
20%
10%
0%
Employed full time Employed part
time
Source: 2004 Florida Health Insurance Study (FHIS)


Exclusively self-
employed


Unemployed Not In Workforce


1 Insured All Year 0 Insured Part of Year 0 Uninsured All Year
50% -
45.2% 44.1% 44.3%

40% 36.7%


30% -
25% -
20% -
I AonoI


No Usual Source of Care Delayed Care
Source: 2004 Florida Health Insurance Study (FHIS)


Implications
In summary, the problem of intermittent health insurance coverage is one that occurs disproportionately among
low-income and minority Floridians, and has negative effects on access to appropriate health care.

Gaps in health care coverage can also result in negative health consequences: those who experience gaps in
coverage are more likely to report delays in seeking care when it is needed, and are less likely to have a usual
source of care, both of which can adversely affect health. Further, people with gaps in coverage are less likely to
seek preventive services than are those who have had continuous health insurance coverage.

In general, people with gaps in coverage are much more like the uninsured than the continuously insured when it
comes to health care. Thus the full impact of uninsurance in Florida is better understood by considering gaps in
coverage as well as a lack of coverage.


Florida Center for Medicaid and the Uninsured


page 3







FHIS
Florida Health Insurance Study


PO BOX 100227
GAINESVILLE, FL 32610


Florida Center for Medicaid and the Uninsured
Shaping Healthcare Policy


Data Source and Methods
The findings presented in this fact sheet are based on data
from the 2004 Florida Health Insurance Study. Telephone
interviews were conducted between April and August of 2004
with 17,435 Florida households, collecting data on
approximately 46,876 individuals under age 65. Telephone
fieldwork was conducted by the Survey Research Center of
the University of Florida's Bureau of Economic and Business
Research. Up to 20 phone calls were made to each household
selected by random-digit dialing. Interviews were conducted in
English, Spanish, or Haitian Creole, at the discretion of the
interviewee. Each interview took approximately 14 minutes to
complete, depending on the size of the household. A full
household enumeration was implemented, and information
was also obtained about health status, access and utilization
of health services, and type of employment. Survey
methodology details are available at http://ahca.myflorida.com/
Medicaid/qualitymanagement/mrp/projects/fhis2004/index.
shtml.
The 2004 Florida Health Insurance Study was funded by the
State Planning Grant (SPG) program of the Health Resources
and Services Administration (HRSA, Grant Number 1-P090
A016 80-01-00), with state level management from Florida's
Agency for Health Care Administration (AHCA), and survey
work conducted by a team from the University of Florida's,
College of Public Health and Health Professions.


FHIS TEAM


FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION
AHCA ADMINISTRATOR: Mel Chang


UNIVERSITY OF FLORIDA
PRINCIPAL INVESTIGATOR: R. Paul Duncan
CO-PRINCIPAL INVESTIGATOR: Allyson G. Hall
PROJECT COORDINATOR: Colleen K. Porter
STATISTICIAN: Cynthia Wilson Garvan
INVESTIGATOR: Christy Harris Lemak
RESEARCH ASSISTANTS: Rebecca J. Tanner
Lorna P. Chorba


HEALTH MANAGEMENT ASSOCIATES
PRINCIPAL: Marshall E. Kelley
SENIOR CONSULTANT Nicola Moulton




University of Florida Home Page
© 2004 - 2010 University of Florida George A. Smathers Libraries.
All rights reserved.

Acceptable Use, Copyright, and Disclaimer Statement
Last updated October 10, 2010 - - mvs