Trends in Care for Uninsured Adults and Disparities in Care by Insurance Status

Abstract

The uninsured fare worse than the insured on various measures, yet there is little evidence regarding trends in care for the uninsured and disparities by insurance status. Given changes in the health care system and the safety net, disparities between insured and uninsured populations may be changing over time. This article considers trends in access, chronic disease control, and heart attack care by insurance status and the disparity in these measures between uninsured and insured nonelderly adults, controlling for demographic characteristics to account for potential changes in the composition of these populations. Rates for the uninsured for all outcomes have generally been stable from the mid-1990s to mid-2000s, with fluctuation in some measures over shorter periods. In addition, there is a persistent disparity between the privately insured and uninsured on access measures. The gap between the uninsured and insured has not narrowed, though disparities generally have not worsened either.