Lack of Health Coverage Among US Veterans From 1987 to 2004

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. Expanded funding for veterans' care is urgently needed; only national health insurance could guarantee coverage to both veterans and their family members.