LIFE TRANSITIONS AND HEALTH-INSURANCE COVERAGE OF THE NEAR ELDERLY

OBJECTIVES. This study addresses three issues. (1) What are demographi c wealth, employment, and health characteristics of near-elderly perso ns losing or acquiring health insurance coverage? Specifically, (2) wh at are the effects of life transitions, including changes in employmen t status, health, and marital status? (3) To what extent do public pol icies protect such persons against coverage loss, including various st ate policies recently implemented to increase access to insurance? MET HODS. The authors used the 1992 and 1994 waves of the Health and Retir ement Study to analyze coverage among adults aged 51 to 64 years. RESU LTS. One in five near-elderly persons experienced a change in insuranc e coverage from 1992 to 1994. Yet, there was no significant change in the mix of coverage as those losing one form of coverage were replaced by others acquiring similar coverage. CONCLUSIONS. Individuals whose health deteriorated significantly were not more likely than others to suffer a subsequent loss of coverage, due to substitution of retiree o r individual coverage for those losing private coverage and acquisitio n of Medicaid and Medicare coverage for one in five uninsured. State p olicies to increase access to private health insurance generally did n ot prevent individuals from losing coverage or allow the uninsured to gain coverage. Major determinants of the probability of being insured were education, employment status of person and spouse, and work disab ility status. Other measures of health and functional status did not a ffect the probability of being insured, but had important impacts on t he probability of having public coverage, conditional on being insured .