Document Type

Master's Culminating Experience

Publication Date



Objectives: To determine the prevalence, predictors, and consequences of underinsurance in the state of Ohio.

Study Design: The investigators created the dependent variables Underinsured, Financial Stress, and Harder to get Health Care using the 2008 Ohio Family Health Survey (OFHS). The sample used for this study included 29,778 respondents, who were adults less than 65 years old and who were continuously insured for the past 12 months.

Results: The study categorized twenty-two percent of the sample respondents as underinsured because they were not able to obtain or delayed needed medical care because of an inability to pay in the past 12 months. A similar percentage reported experiencing financial stress (problems paying medical bills) and that it was harder getting health care compared to 3 years ago.

Conclusions: One in five sample respondents were underinsured. Almost sixty percent of those who are underinsured reported having financial stress. Nearly half of the underinsured found that it was harder to get needed healthcare compared to three years ago. The following variables increased the likelihood of being underinsured: older age, female sex, Black race, public and directly purchased insurance, less than a college education, income less than 300% of the federal poverty level, worsening health status, and special health care needs. The Patient Prevention and Affordable Care Act policies will likely target and impact underinsurance. Individual states such as Ohio will need to continue to describe those underinsured in order to target this group through health policy.