Part-year Coverage and Access to Care for Nonelderly Adults

Background: The association between uninsurance and reduced access to care is well known. Few studies, however, examine the relationship between the length of time without coverage and measures of access to care among adults. Objectives: To examine the association between access to care and the length of time without coverage during a 12-month period among nonelderly adults. Methods: Multivariate logistic regression models of 15 measures of access to care are estimated, using data from the 2005-2010 Medical Expenditure Panel Survey. These models control for length of time without coverage and other factors. The study then examines how access to care varies by the length of time without coverage. Results: There were large differences in access to care between those with and without coverage for all 12 months. For most of the measures, those lacking coverage for 1-5 months also had less access to care compared with those covered all 12 months. Lastly, for most of the measures, those lacking coverage for all 12 months had less access to care compared with either those lacking coverage for 6-11 months, or those lacking coverage for 1-5 months. Conclusions: The study shows the importance of considering the length of time without coverage when examining access to care of the uninsured. Even relatively short periods of uninsurance may be associated with some barriers to health care. In contrast, having some coverage during the year is associated with greater access to care than having no coverage at all.