Myths about Health Insurance

Myth: The uninsured are young adults who don’t want health insurance:

49 percent of the uninsured are between the ages of 18 and 34. However, according to a 2005 Pennsylvania Insurance Department survey, and as explored in a previous myth, the reason they are uninsured is predominantly cost, not that they don’t want coverage.  In addition, this population has significantly lower financial stability and is at a greater risk or financial difficulty from health care related expenses.  Making an affordable quality health insurance product available to them would allow many of these young adults to purchase health insurance coverage.

It is also important to consider that 37 percent of the uninsured, according to the same survey, are between the ages of 34 and 65.  This number could potentially continue to grow as more and more employers stop offering health insurance to their employees.  At the same time, this age group faces more difficulty obtaining insurance on their own or through an employer because they are considered high risk because of their age.  In addition, there is a greater chance they suffer from a pre-existing health condition.  This means that even if they can find insurance the premiums are often unaffordable.

Myth: The uninsured are able to get health care without too much trouble even without insurance.

Not true, the access to affordable health care services is greatly diminished for individuals lacking health care insurance. The uninsured are more likely to delay care and when they do seek care it is often in the most expensive setting, the emergency room. Paying out-of-pocket for this expensive care that would more appropriately be handled in a different and more cost-effective care setting is an increasingly difficult task.  Since 1981 there has been a nearly six-fold increase in the proportion of families filing for bankruptcy because of medical expenses.  Ensuring that individuals have affordable health insurance will allow individuals to seek preventative care at appropriate levels and hopefully stem the tide of mounting medical expenses forcing families to file bankruptcy.

Myth: It’s easy for individuals and small businesses to buy insurance.

Not true, because the risk pool is so small, and through adverse selection, health insurance rates are generally much higher for these markets.  This is not helped by the fact that Pennsylvania is one of only two states that does not regulate the factors insurance companies can use in rate setting. This leaves the most vulnerable citizens - those with pre-existing conditions - either unable to find insurance, or when they do find it, with unaffordable premiums.  At the same time, small employers see their premiums rise each year, often times to a point they can no longer afford to pay.

Myth:  There are no serious adverse health affects resulting from a lack of health insurance.

Not true, according to the Kaiser Family Foundation uninsured adults are three times more likely to delay seeking care than insured adults resulting in a higher likelihood of being diagnosed with a disease in the advanced stage.

Additionally, Families USA released a study just this week that estimates that approximately 710 working-age Pennsylvanians in 2006 died as a result of lacking health care.  That is nearly 2 people every day.  Nationally, lack of health insurance was responsible for twice as many deaths as homicide in 2006.

Myth:  Most of the uninsured are uninsured by choice.

Not true, according to a 2005 Pennsylvania Insurance Department survey, 70% of uninsured adults listed cost, premium increases, and affordability as the major reason for not having health insurance.  Additionally, 20% cited loss of employment as a reason.  Only 12% listed "no reason in particular" for not having health insurance.  These findings indicate that the uninsured want insurance but simply cannot afford it.

Myth: The number of uninsured is inflated because most people are only uninsured briefly.

Not true, according to the 2005 Pennsylvania Insurance Department Health Insurance Survey, of the nearly 800,000 uninsured individuals 56% reported being uninsured for one year or longer. Of those, 27% reported having gone without health insurance for five years or longer.

Myth: Being uninsured doesn’t affect me — I have insurance.

In reality, the cost of providing care for the uninsured is shifted to those who have health insurance and to taxpayers. In Pennsylvania, an estimated 6.5% of every insurance premium paid goes to cover the cost of providing health care for the uninsured. Additionally, a large portion of uncompensated care, health care provided by a medical facility that is not paid by the patient, is paid for with federal and state tax money.

Myth: My employer provides me with health insurance so I don’t have to worry.

While employer based health insurance is the most common type of health insurance, a recent study by the Economic Policy Institute found that Pennsylvania was losing employer provided health insurance in numbers at a rate only second to California. Specifically, between 2000 and 2006, 491,392 Pennsylvanians lost their employer provided health insurance. Many employers are finding it difficult to continue to pay the rising costs of health insurance premiums and are no longer offering health insurance benefits.

Myth: Most of the uninsured are not employed.

In fact, of the nearly 800,000 uninsured adults in Pennsylvania, 71% are employed and 44% of them are employed full time. Many of the uninsured work for small businesses that would like to offer health insurance for their employees but can not keep up with rising premiums, or they work in low wage jobs and can not afford to purchase health insurance from their employer or in the individual insurance market.

GOVERNOR'S OFFICE OF HEALTH CARE REFORM | CONTACT US | COMMONWEALTH OF PA