Health insurance regain after a spell of uninsurance: A longitudinal comparison of youths with and without disabilities transitioning into adulthood

Objective: To compare uninsured youths with and without disabilities aging into adulthood on insurance regain over three years. Design: This study included 1430 youths between the ages of 15 and 25 who lost insurance between 2001 and 2004. Data were from the Survey of Income and Program Participation 2001, a panel survey administered by the US Census Bureau. We categorized respondents as without disabilities, with nonsevere disabilities, or with severe disabilities. Persons with nonsevere disabilities experienced difficulty with functional activities and activities of daily living. Persons with severe disabilities were unable to perform or required assistance to perform functional activities and activities of daily living. To examine the association between regaining insurance and disability, we conducted a parametric event history analysis adjusting for gender, race, ethnicity, age, work/school status, and poverty. Findings: Seventy percent of youths without disabilities, 59% of youths with nonsevere disabilities, and 75% of youths with severe disabilities regained insurance during the study period. Estimated median duration of uninsurance was 4.5 months for persons without disabilities, 10.5 months for persons with nonsevere disabilities, and 4 months for persons with severe disabilities. The hazard of regaining insurance was significantly associated with disability status. Persons with nonsevere disabilities were significantly less likely to regain insurance compared to peers without disabilities after adjusting for gender, race, ethnicity, age, work and school status, and poverty status. (HR: .71, 95% CI: 53, .94) Conclusions: Disability severity was associated with regaining insurance among the 15 to 25 year old youths in this study.