Individual Health Coverage

Key Questions

What is the Individual Health Coverage Market?

This market, sometimes called the “non-group market,” includes any health insurance policies directly purchased by an individual rather than through a group, such as an employer.

How Many People Are Covered in the Individual Health Coverage Market?

A total of 26.777 million had direct purchase health insurance in March 2009 (DeNavas-Walt: Table C-3).  However, 10.103 of these were age 65 or older–the vast majority of which represented Medicare supplemental policies intended to cover gaps in Medicare coverage–leaving 16.6 million non-elderly covered by this market.

But the potential market for such coverage arguably also should include any uninsured who theoretically could have purchased coverage in this market, but did not. There were 45.7 million nonelderly uninsured in March 2009 (DeNavas-Walt: Table C-3); in 2008, 82.6% of such individuals were in families headed by full- or part-time workers (Fronstein: Figure 9). However, only 20.9% of uninsured workers turned down coverage offered to them (Fronstein: Figure 18), implying that only 17.4% of the uninsured under 65 have theoretical access to employer-provided coverage, leaving 38.3 million non-elderly uninsured and up to 646,000 elderly uninsured (DeNavas-Walt: Table C-3) whose only source of private insurance would be in the individual market. So leaving aside the elderly who purchasing supplemental coverage, the total market for persons potentially seeking stand-alone individual health coverage is about 55.6 million in 2009.

References

  • DeNavas-Walt, Carmen, Bernadette D. Proctor, and Jessica C. Smith. U.S. Census Bureau, Current Population Reports, P60-236, Income, Poverty, and Health Insurance Coverage in the United States: 2008, U.S. Government Printing Office, Washington, DC, 2009. [Full Text (pdf)]
  • Fronstin, Paul. Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2008 Current Population
    Survey
    . EBRI Issue Brief, no. 321 (Employee Benefit Research Institute, September 2008). [Full Text (pdf)]

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