Insuring Our Nations Veterans

Photo courtesy the City of North Charleston, SC (Creative Commons / Flickr)

Photo courtesy the City of North Charleston, SC (Creative Commons / Flickr)

Myth: All United States military veterans receive health insurance.

Fact: More than 1.5 million U.S. veterans were uninsured in 2010.

A recent article in the American Journal of Public Health examined the impact of the Affordable Care Act on military veterans and highlighted the unmet health care needs of the men and women who have risked their lives protecting our country. The authors analyzed the 2010 National Survey of Veterans to (1) establish the percentage and health needs of uninsured veterans, (2) determine how many of those uninsured veterans are eligible for Medicaid expansion, and (3) compare the health status and demographics between uninsured veterans and those with health insurance.

The researchers separated 8,710 survey responses into three categories: (1) uninsured veterans who were eligible for Medicaid expansion, (2) uninsured veterans who were not eligible for Medicaid expansion (and therefore more likely to purchase health insurance through the exchange), and (3) veterans who reported having health insurance at the time of the survey.

The analysis revealed that although the majority of veterans have health insurance through an employer, about 7% of veterans are uninsured. Of that 7%, which corresponds to nearly 1.5 million veterans, over 50% are eligible for Medicaid based on the expansion criteria. The authors also identified the proportion of uninsured veterans who are eligible but live in the 15 states that have refused to expand their Medicaid programs. Almost 200,000 of the veterans in this study will not have Medicaid coverage because they live in one of these states.

The study found that uninsured veterans were more likely to be young, Black, less educated, unmarried, and to have served in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn. Based on the study’s findings, the ACA will provide opportunities for coverage through the exchanges or Medicaid expansion.

Commentary

Historically, Medicaid has accounted for a small proportion of veteran health care needs, but it may become a more prominent payer for eligible, currently uninsured veterans who live in states that have expanded their Medicaid programs under the Affordable Care Act.

For the veterans who live in states that have refused to expand, their options are limited. Some may be eligible for Veterans Affairs (VA) coverage or for subsidies to purchase insurance through the exchanges, but it is likely that many of these veterans will remain uninsured.

Given the demographic description of uninsured veterans as poor, young, Black, and less educated, the fractured system of veteran health insurance exposed by this study contributes to the costly health disparities burdening the U.S. health care system.

The authors note that although the proportion of uninsured veterans (7%) is alarming, the rate has remained steady or slightly decreased (from 7.7%) over the last two decades.

Still, our military veterans deserve improved policies increasing their access to insurance and the expansion of Medicaid in the states that are still holding out.

Tsai, J. and Rosenheck, R. AJPH. 2014; 104 (3): e57-e62.

by

Megan Douglas, JD

4 Replies to “Insuring Our Nations Veterans”

  1. I have been under the assumption that all veterans can get medical care through their closest Veteran’s Hospital… Is this not correct?

  2. How is access to quality healthcare not a guarantee from having risked one’s life to protect one’s country?! There should not be a single veteran who does not have healthcare coverage. Thank you for bringing this incredibly important statistic to everyone’s attention!

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