The uninsured "access gap" and the cost of universal coverage

by Stephen H Long, M. Susan Marquis

This study estimates the effect of universal coverage on the use and cost of health services by the uninsured. Adults lacking insurance for a full year have about 60 percent as many ambulatory contacts and about 70 percent of the inpatient hospital days they would have if they were covered by insurance. This "access gap" is only slightly smaller for children. Providing universal coverage would increase ambulatory contacts and inpatient days by less than 4 percent a year. The dollar cost of these new services is estimated to be $19.9 billion--a 2 percent increase in total health spending.

Originally published in: Health Affairs, Spring, 1994, pp. 211-220.

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