Measuring Adequacy of Coverage for the Privately Insured

New State Estimates to Monitor Trends in Health Insurance Coverage

This article examines the adequacy of private insurance for adults and children. In response to increasing costs, private insurance programs have increased cost-sharing for their members, but little is known about changes to out-of-pocket spending at the national level.

The authors analyzed national data from the Household Component of the Medical Expenditure Panel Survey and state data from the Current Population Survey. They used a two-sample modeling approach to estimate the ratio of out-of-pocket spending to family income.

Key Findings:

  • Almost 8 percent of privately-insured adults and 3 percent of children live in households that pay more than 10 percent of their income on out-of-pocket health care costs.
  • The proportion of children and adults who paid more than 10 percent of family income for out-of-pocket health care costs varied substantially between states and over time.

A more nuanced understanding of underinsurance, as well as uninsurance should help shape health care research and policy.