Underinsurance in the United States: An interaction of costs to consumers, benefit design, and access to care
Underinsurance is most commonly defined as the state in which people with medical coverage are still exposed to financial risk. This article argues that suitable health insurance coverage should also be assessed in terms of the adequacy of specific benefits coverage and access to care. Underinsurance can be understood conceptually as comprising three separate domains: (a) the economic features of health insurance, (b) the benefits covered, and (c) access to health services. The literature provides ample evidence that people who are underinsured face the same access to care barriers and have high financial risk as those who are completely uninsured. In response to the growing recognition of the problems associated with underinsurance, the Obama Administration's Patient Protection and Affordable Care Act of 2010 includes a multitude of provisions designed to enhance access to care (especially primary care), limit costs to consumers, and to assure a minimum set of benefits.
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