Adults with individual and employment-related health insurance report similar, often good, access to care
Research Activities, February 2012, No. 378
Persons who have individual health insurance report having similar access to care as those covered through employment-related insurance, according to a new study. Several provisions in the recently-passed Patient Protection and Affordable Care Act increase the generosity of individual insurance to more closely match the generosity of employer-related coverage.
Steven C. Hill, Ph.D., a researcher at the Agency for Healthcare Research and Quality (AHRQ), compared 1,097 adults (ages 18 to 64 years) with individual private health insurance and 26,405 adults covered by employment-related private health insurance. Adults covered by individual plans were less likely than those covered by employment-related plans to have prescription drug coverage (69.5 vs. 94.0 percent), dental care coverage (22.0 vs. 74.2 percent), or coverage through a health maintenance organization (25.7 vs. 42.9 percent). In addition, mean annual out-of-pocket expenses for adults with individual insurance was nearly twice that of those with employment-related private insurance ($1,154 vs. $682).
Both groups were similar in the proportions having a usual source of care or any medical visits in the past year. However, adults with individual insurance were less likely to report having an illness or injury requiring immediate care (20.7 vs. 25.3 percent). Similar proportions of both groups felt they could get needed care as soon as they wanted. The findings were based on analysis of data from the AHRQ Medical Expenditure Panel—Household Survey for 2002 through 2007.
More details are in "Individual insurance and access to care," by Dr. Hill in the Summer 2011 Inquiry Journal 48(2), pp. 155-168. Reprints (AHRQ Publication No. 12-R002) are available from the AHRQ Publications Online Store .