When a Community Has a Higher Rate of Uninsured Residents, Does that Affect Care for Those with Insurance?

Investigating the Impact of High Community Rates of Uninsurance on Health Care Quality and Access

Field of Work: The impact of high rates of uninsurance in communities on those adults who have insurance

Problem Synopsis: Existing studies of the issue were not large enough and had methodological shortcomings.

Synopsis of the Work: In 2009 and 2010, researchers at the David Geffen School of Medicine at the University of California-Los Angeles (UCLA) and the RAND Corporation measured the impact of high local rates of uninsurance on access to care and the quality of care among adults with health insurance. The researchers studied 86,928 adults with private health insurance or Medicare in 200 metropolitan areas across the country.

Key Findings/Results: The research team reported in “Spillover Effects of Community Uninsurance on Working-age Adults and Seniors: An Instrumental Variables Analysis,” published in Medical Care (September 2011) that a higher rate of uninsurance in a community had a negative effect on:

  • Access to care among working-age people with private insurance
  • Satisfaction with care among working-age people with private insurance
  • Access to care among seniors with Medicare coverage