Voices of underinsured Kansans

For most people in the United States, health insurance is the primary means by which they gain access to health care services. However, insurance guarantees neither adequate coverage nor access. Recent national reports indicate that tens of millions of people have insurance that inadequately covers their health care expenses, a situation that results in adverse consequences including financial strain, medical debt, and postponing needed care. These individuals are underinsured. Moreover, policy and employer efforts to increase enrollment via affordable health plans have increased the number of persons who are underinsured. While extant data quantifying the prevalence and demographics of underinsured Kansans are very limited, even less is known about the phenomenological aspects of the issue. As part of a larger mixed methods examination of underinsurance in Kansas and to gain an in-depth understanding of how underinsurance impacts families, in fall 2009, we conducted structured interviews with 10 underinsured Kansans. They came from different walks of life such as farming, business, and teaching, lived in different parts of the state, and ranged in age from 25 to 78. The qualitative data analyses used grounded theory to identify emergent themes and develop personal narratives. In presenting findings, we will discuss 1) the analytic methodology used, 2) when and how participants realized they were underinsured, 3) challenges people faced due to being underinsured (e.g., financial strain), 4) individuals' experiences with providers, and 5) biopsychosocial dynamics noted such as worsened health and new medical conditions stemming from postponed care and psychological distress.