Spells without health insurance: distributions of durations and their link to point-in-time estimates of the uninsured.

To be able to design effective policies that will provide financial access to medical care to the uninsured, we need to know how many people experience long versus short spells without health insurance. Previous studies of the characteristics of the uninsured have relied almost exclusively on data from a point in time. Using the Survey of Income and Program Participation (SIPP), this paper provides a link between the distributions of four characteristics of the uninsured at a point in time and the expected uninsured spell lengths of people in specific subgroups of each characteristic. Our findings indicate that half of all uninsured spells end within 4 months while only 15% last longer than 24 months. Also, people who are employed (either full-time or part-time) in the first month of an uninsured spell are highly likely to have short uninsured spells, while people who are unemployed or out of the labor force are more likely to have long uninsured spells. This implies that efforts to increase health insurance coverage via employer mandates should proceed cautiously until we know how many people with long uninsured spells are employed.