Uninsured Spells of the Poor: Prevalence and Duration

The number of persons in the United States without health insurance, particularly those lacking private health insurance, is increasing. Although there is a large body of research documenting the insurance status of people in poverty at a point in time, the duration of spells without health insurance, and the duration of poverty spells, much less attention has been paid to the dynamics of spells without health insurance among those in poverty. The results presented here, based on data from the 1990 Survey of Income and Program Participation (SIPP), conclude that the typical uninsured spell is longer for the uninsured poor (roughly 8.3 months) than for the uninsured nonpoor (roughly 6 months) and that the duration of spells has increased over time. The findings suggest that over 40 percent of the uninsured at a point in time are chronically uninsured and poor or near poor. The cost of obtaining health care is particularly prohibitive for this group, with serious implications for the reform of health care.