David U. Himmelstein ^1*, Karen E. Lasser ², Danny McCormick ³, David H. Bor ³, J. Wesley Boyd ³, Steffie Woolhandler ³

¹ Harvard Medical School
² Harvard medical School/Cambridge Hospital
³ Harvard Medical School/Cambridge Hospital

^* To whom correspondence should be addressed. E-mail: dhimmelstein{at}challiance.org.

	Abstract

Objectives. Veterans Administration health care enrollment is restricted to veterans with service-connected problems and those who are poor. We sought to determine how many veterans were uninsured, trends in veterans’ coverage, and whether uninsured veterans lacked access to medical care.

Methods. We analyzed annual data from 2 federal surveys, the Current Population Survey for the years 1988 to 2005 and the National Health Interview Survey for 2002 to 2004.

Results. Nearly 1.8 million veterans were uninsured and not receiving Veterans Administration care in 2004. The proportion of working-age veterans lacking coverage peaked in 1993 at 14.2%, fell to 9.9% in 2000, and rose steadily to 12.7% in 2004. Uninsured veterans had substantial access problems; 51.4% had no usual source of care (vs 8.9% of insured veterans), and 26.5% reported failing to get needed care because of the cost (vs 4.3% of insured veterans).

Conclusions. Many US veterans are uninsured and lack adequate access to health care.

Key Words: Insurance, Health Financing, Health Policy, Access to Care, Health Service Delivery

eLetters: