Uninsured people with disabilities confront substantial barriers to health care services

Despite social “safety net” programs, many U.S. residents with disabilities lack insurance coverage and thus risk financial barriers to accessing care, according to a study in the October 2011 issue of Disability and Health Journal. The study objectives were to characterize working-age adults with disabilities who lack health insurance and to examine their self-reported barriers to care. The authors conducted analyses of nationally representative Medical Expenditure Panel Survey data from 2000 through 2006.

Results

During this time period, 14.8% of working-age U.S. residents lacked health insurance, including 11.6% of people with disabilities. Focusing only on uninsured individuals, people with disabilities were significantly (p = .001) more likely than those without disabilities to have a usual source of care. However, on six other access measures (those that comprised our composite indicator of access barriers), uninsured adults with disabilities reported barriers significantly (p = .001) more often than did those without disabilities: 36% of uninsured adults with disabilities reported being unable to get necessary medical care, compared with 9.5% of uninsured, nondisabled adults; and 26.9% of uninsured adults with disabilities reported being unable to get necessary medications, compared with 5.3% of uninsured adults without disabilities.

Having a cognitive impairment produced the largest adjusted odds ratio (AOR) of reporting any access barrier (1.64, 95% CI 144-1.87), while having lower body functional limitations or hearing deficits also produced relatively high AORs (1.47, 1.32-1.65 and 1.48, 1.11-1.98, respectively).

Conclusions

Uninsured individuals with disabilities confront significantly more barriers to accessing care than do nondisabled adults without health insurance. The association is stronger for certain types of disabilities, suggesting areas requiring particular attention.