Who’s Not Covered? Demographic and Health Profiles of Uninsured Americans Ages 51–64

Overview

This brief highlights a major coverage gap among U.S. adults aged 51–64, a group with elevated health needs due to age-related chronic conditions. Using data from the 2022 Health and Retirement Study, Rodlescia S. Sneed examines demographic disparities among the uninsured and explores the health consequences of lacking insurance during this critical stage of life. The findings point to clear inequities and call for policy solutions that improve access to care ahead of Medicare eligibility.

Key Findings

• Nearly 6 million adults (13.7%) aged 51–64 are uninsured in the U.S.
   
• Individuals most likely to be uninsured include those who are low-income, unpartnered, not employed full-time, male, and Hispanic.
   
• Cost remains the primary barrier to coverage, followed by job-related disruptions and lack of employer-sponsored insurance.
   
• Uninsured individuals are less likely to use preventive services, manage chronic illnesses, or maintain consistent access to primary care.
   
• Medication adherence is significantly lower among uninsured individuals with hypertension and diabetes, increasing their risk of serious health complications.
   
• Uninsured adults rely more heavily on emergency departments for routine care, contributing to higher healthcare costs and fragmented care.

Policy Implications

The brief underscores the need to expand affordable insurance options for adults nearing retirement. Key proposals include:

• Lowering the Medicare eligibility age to provide earlier access to coverage.
   
• Enhancing ACA marketplace subsidies to make private plans more affordable.
   
• Introducing a public health insurance option to expand choices and affordability.
• These strategies aim to reduce disparities, improve chronic disease management, and reduce unnecessary emergency care use among this vulnerable population.

Research Context

Findings are based on nationally representative data and adjusted for demographic factors. This analysis offers timely insights for policymakers working to close insurance coverage gaps and promote health equity for older adults.