HEALTH POLITICS: Do the Underinsured Vote?

The Underinsured—aka people who may think they have enough insurance until they get sick and find out otherwise— have been getting a fair amount of attention recently, particularly since the Commonwealth Fund reported that there are now about 25 million underinsured people, up 60 percent in four years. These are the people, according to several studies, who delay or do without some of their health care that those of us lucky to have decent coverage may take for granted. We listened in the other day to a webcast (click here to see it) sponsored by the Association of Health Care Journalists featuring Commonwealth assistant vice president Sara Collins;Helen Darling, president of the National Business Group on Health; and Mila Kofman, Maine's superintendent of insurance.

One reason we're interested in the underinsured, who tend to be middle class, is that they may turn out to be a force in the November elections. As Julie Rovner wrote in Congress Daily (subscription)  recently:

It has long been something of a political truism that the uninsured don't vote. But at 47 million strong, and with 80 percent of those connected to the workforce, that seems less true than it used to be. But the real sleeper health issue of this campaign is not the uninsured but rather the underinsured.

Definitions vary, but generally the underinsured are those who spend, or are at risk of spending, more than 10 percent of their income out-of-pocket on healthcare bills and less if their income is below twice the poverty level—about $42,000 for a family of four.

As Collins noted on the webcast, health care costs are hitting the middle class at a time when they are feeling the squeeze from rising gas, energy, and food costs. Helen Darling, whose group represents employers concerned about health care costs and quality, agreed that for many workers, "the ability to absorb these increases is just not there."

Their dialogue helps explain why we get a tad exasperated when we hear people say that the economy could eclipse health care as an issue next year. We see health care as a big part of people's economic anxieties and burdens (and their employers). So next time someone tells you we can't afford to fix health care, tell them au contraire, we can't afford not to.