Rising Numbers of Uninsured in Moderate and Middle Income American Families

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Family health insurance

Two of five (41%) working-age Americans with incomes between $20,000 and $40,000 a year were uninsured for at least part of the past year, a dramatic and rapid increase from 2001 when just over one-quarter (28%) of those with moderate incomes were without health insurance coverage, according to a new report from The Commonwealth Fund, Gaps in Health Insurance: An All-American Problem, prepared for the Fund's Commission on a High Performance Health System.

Lower-income adults were still the most likely to be uninsured. The vast majority of the uninsured are in working families: of the estimated 48 million working-age Americans uninsured during the year, 67% were in families where at least one person was working full-time.

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"The jump in uninsured among those with modest incomes is alarming, particularly at a time when our economy has been improving," said Commonwealth Fund President and study co-author Karen Davis. "If we don't act soon to expand coverage to the uninsured, the health of the U.S. population, the productivity of our workforce, and our economy are at risk."

The study finds a startling number of adults are now grappling with medical debt--unpaid medical bills. One of five (21%) adults, including insured and uninsured, currently has medical debt they are paying off over time, and one-third (34%) either had medical bill problems in the past year or were paying off accrued medical debt. The survey of adults ages 19 to 64 reveals that medical debt is not an issue for the uninsured alone. Nearly two-thirds (62%) of adults with medical bills or debt problems said that they or their family member were insured when they incurred the debt.

The survey looked at the medical consequences families face when they go without health

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