At least 44% of the uninsured are uninsured by choice, and the number could be much higher than that. An Urban Institute study found that:
- One in every four uninsured persons is eligible for Medicaid or SChip, but has not enrolled.
- One in five has a family income in excess of $58,000 and presumably can afford coverage.
This is a minimum estimate. Of those who earn less than $58,000, there are undoubtedly many who can afford coverage because:
- They have access to an employer plan, (almost one in five uninsured turn down employer coverage.)
- Even if their employer does not provide health insurance, they have opportunities to work for employers who do, but choose not to.
- They are young and healthy or live in rural areas and face premiums much lower than the $9,961 annual premium assumed by the Urban Institute scholars.
- They are near retirement and can draw on assets to pay premiums until they become eligible for Medicare.
If you missed this story, it is understandable. Our friends at Commonwealth and Health Affairs have it listed under "More Than Half of Uninsured Cannot Afford Coverage and Are Not Eligible for Public Programs," which makes you wonder who is writing their headlines these days. To be fair, the authors of this study are the source of misleading headlines. They started with a serious study of how many millions of the uninsured can afford coverage and turned it into unsupportable claims about who cannot afford it. Surprisingly, I do not believe the words "uninsured by choice" appear anywhere in the study itself.