Expert Commentary

Uninsured veterans and family members: Who are they and where do they live?

2012 report by the Urban Institute and the Robert John Wood Johnson Foundation on the Affordable Care Act and uninsured veterans.

Daughter and military father (iStock)

More than a million U.S. military veterans members lack health insurance. The Affordable Care Act (ACA), often referred to as Obamacare, set to be fully operational as of 2014, may increase coverage for many uninsured veterans, but to what extent?

A 2012 report by the Urban Institute and the Robert Wood Johnson Foundation, “Uninsured Veterans and Family Members: Who Are They and Where Do They Live?” analyzes data from the 2010 American Community Survey (ACS) by the U.S. Census Bureau and the 2009 and 2010 National Health Interview Surveys (NHIS). The report seeks to identify uninsured non-elderly veterans and to estimate the levels of medical coverage by state.

Results of the report include:

  • Approximately 1 in 10 — 1.3 million — of the country’s 12.5 million nonelderly veterans did not have health insurance coverage or access to Veterans Affairs (VA) health care as of 2010. When family members of veterans are included, the uninsured total rises to 2.3 million. An additional 900,000 veterans use VA health care but have no other coverage.
  • “A variety of factors, including Medicaid eligibility thresholds for adults, the characteristics of labor market, and the proximity of veterans to VA facilities, may contribute to variation across states in uninsurance rates among veterans.”
  •  “Uninsured veterans are less likely than insured veterans to report service-related disabilities [although] 17.3% of the uninsured have either a service-related disability or a functional limitation.” They are more likely to be male (90.4%), non-Hispanic white (70.4%), unmarried (58.2%) and earned a high school degree (40.7%). More than 40% are younger than 45 years old.
  • Nearly 50% of uninsured veterans have incomes at or below 138% of the Federal Poverty Line ($30,429 for a family of four in 2010). Under the ACA, these would qualify for coverage as of January 2014. Another 40.1% of veterans and 49% of their families have incomes that qualify for new subsidies through health insurance exchanges with the ACA.
  • A provision of the ACA mandates that each state establishes a health insurance exchange or a marketplace of health providers and plans that individuals and small businesses can buy into. While the exchanges do not need to be up and running until 2014, some states have already started the process.
  • The uninsured rate is 12.3% in states with the least progress on exchange implementation, compared with 9.6% to 9.8% for veterans in states with most progress to health insurance exchange implementation.

The authors conclude that “the ACA could offer new routes to health insurance coverage for veterans and their family members,” but also warn that “expanded coverage among these groups will not solve every access problem.”

Keywords: veterans, Obamacare

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