Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Table of Contents


Front Matter
Executive Summary
1. Why Health Insurance Matters
2. The Dynamics of Health Insurance Coverage
3. Who Goes Without Health Insurance? Who Is Most Likely To Be Uninsured?
4. Analytic Plan
Appendix A: A Conceptual Framework for Evaluating the Consequences of Uninsurance: A Cascade of Effects
Appendix B: Measuring Insurance Coverage and Insurance Rates
Appendix C: Data Tables
Appendix D: Multivariate Analysis
Appendix E: Glossary
Appendix F: Biographical Sketches
References