Cost and Access Challenges: A Comparison of Experiences Between Uninsured and Privately Insured Adults Aged 55 to 64 with Seniors on Medicare

This analysis looks at the difficulties uninsured people ages 55-64 have accessing and affording health care in 2010. Four in 10 of these near-seniors report having unmet health care needs or delaying treatment, while three in 10 uninsured near-seniors lived in families reporting problems paying their medical bills largely due to the cost.

Seniors on Medicare report problems accessing care at a significantly lower rate than uninsured near-seniors and at a similar rate to near-seniors with private insurance, after controlling for differences in demographics and health status.

Today near-seniors may face difficulties obtaining comprehensive health insurance in the individual market because their age and health status can result in high, unaffordable premiums. Starting in 2014, the Affordable Care Act will create new options to purchase health insurance, barring higher premiums due to pre-existing conditions and limiting premium adjustments based on age. The full analysis includes trend data and comparisons to insured near-seniors and seniors with Medicare.

Issue Brief (.pdf)