Reasons for Uninsured Americans

The number of Americans without any form of health care insurance continues to rise. The myths that surround the uninsured, such as they are all poor, uneducated or choose not to carry health insurance, are largely false. The specific reasons why millions of American citizens do not have health care coverage can vary greatly depending upon each person's situation. A few main causes block access to affordable health care coverage for millions of U.S. citizens.

Cost

• One of the biggest reasons for uninsured Americans is the rising cost of health care coverage. Those with group insurance plans through an employer are paying higher monthly premiums, yearly deductibles, and office visit and prescription copayments. These high costs cause some employees to opt out of employer-based health insurance. Small-business owners and the self-employed have to buy stand-alone or non-group insurance policies. The costs of these types of health insurance policies are higher than group policies and can become unaffordable to small-business owners and self-employed individuals.

Insurer Risk

• Insurers for stand-alone or non-group insurance policies assess the likelihood of an insurance applicant's need for expensive medical care, referred to as insurer risk. If the insurance company determines that the applicant will in all likelihood seek out high-cost medical care, the company may decline the application for health insurance, leaving the person uninsured. If the company doesn't deny the application, it charges the applicant a high-risk premium as well as increases the dollar amount of yearly out-of-pocket expenses.

Eligibility

• Even if an employer offers health insurance benefits, many employees are not eligible to participate. Generally, this is because either they are new hires and still in the probationary work period, usually the first 90 days of employment, or they are part-time employees. Many employers do not offer health insurance to employees who work less than 40 hours a week. For employers who do offer health insurance to part-time employees, the cost becomes an additional reason why those employees decide not to participate.