Health insurance in the United States is provided through a fragmented system of employer-sponsored coverage for most citizens and government-sponsored coverage for the low-income and elderly population. A large and growing number of Americans, however, have neither employer-sponsored nor government-sponsored health insurance, and either remain uninsured or purchase individual policies on the private market. This fragmented system leads to gaps in health care coverage as individuals cycle in and out of coverage and between various forms of coverage. Moreover, changes in the way Americans work -- with moves, job changes, and freelancing becoming increasingly common -- lead to further instability in health insurance and health care.

Given this instability, it is reasonable to ask what effect disruptions in health insurance and health care provider have on access, use, and quality of care. This Issue Brief explores this question and presents evidence demonstrating that unstable health insurance and gaps in health insurance coverage can put individuals and families at financial risk, add to the administrative costs of care, and, perhaps most importantly, adversely affect the quality of health care.

For the complete document, please see the attached PDF version.