Differential Health Insurance Coverage within Families: Evidence from the National Health Interview Survey.

Diane S. Shinberg, University of Memphis

This paper addresses health insurance in the U.S. from a family perspective using data from the 2004 National Health Interview Survey. To capture the complex configurations of health insurance among family members, families with 2+ members are characterized by whether members have comprehensive health insurance defined as: uniformly insured, patchwork insured, insurance gaps, and uniformly uninsured. The problem of lack of health insurance at the family level is extensive—with 63.8 million Americans living in families in which one or more kin are uninsured (another 5.2 uninsured live alone), and 47.8 million Americans living in patchwork insured families. Net of individual level insurance status, family health insurance status is an important, though underappreciated, enabling factor in access to health care, especially for adults. Health policy that continues to frame lack of insurance coverage at the individual level will miss capitalizing on efficiencies of families in pooling and distributing resources.