Life transitions and health insurance coverage of the near elderly.

TitleLife transitions and health insurance coverage of the near elderly.
Publication TypeJournal Article
Year of Publication1998
AuthorsSloan, FA, Conover, CJ
JournalMed Care
Date Published1998 Feb
ISSN Number0025-7079
KeywordsDeath, Employment, health policy, Health Services Research, Health Status Indicators, Humans, Insurance Coverage, Life Change Events, Medicaid, Medically Uninsured, Medicare, Middle Aged, Retirement, Spouses, United States

OBJECTIVES: This study addresses three issues. (1) What are demographic wealth, employment, and health characteristics of near-elderly persons losing or acquiring health insurance coverage? Specifically, (2) what are the effects of life transitions, including changes in employment status, health, and marital status? (3) To what extent do public policies protect such persons against coverage loss, including various state policies recently implemented to increase access to insurance?

METHODS: The authors used the 1992 and 1994 waves of the Health and Retirement Study to analyze coverage among adults aged 51 to 64 years.

RESULTS: One in five near-elderly persons experienced a change in insurance coverage from 1992 to 1994. Yet, there was no significant change in the mix of coverage as those losing one form of coverage were replaced by others acquiring similar coverage.

CONCLUSIONS: Individuals whose health deteriorated significantly were not more likely than others to suffer a subsequent loss of coverage, due to substitution of retiree or individual coverage for those losing private coverage and acquisition of Medicaid and Medicare coverage for one in five uninsured. State policies to increase access to private health insurance generally did not prevent individuals from losing coverage or allow the uninsured to gain coverage. Major determinants of the probability of being insured were education, employment status of person and spouse, and work disability status. Other measures of health and functional status did not affect the probability of being insured, but had important impacts on the probability of having public coverage, conditional on being insured.

User Guide Notes

Endnote Keywords

Socioeconomic Factors/Wealth/Health Status/Health Insurance Coverage/Employment/Marital Status/Disability/Disability/Medicare/Medicaid/Public Policy

Endnote ID


Alternate JournalMed Care
Citation Key6608
PubMed ID9475467
Grant ListR03 HS08614-01 / HS / AHRQ HHS / United States