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Insight on the Issues

Health Insurance Coverage for 50- to 64-Year-Olds

Access drops as costs rise and employer-sponsored plans decline; health care law promises help

The Affordable Care Act (ACA) promises to improve access to adequate, affordable health care coverage for all older adults, especially for those with lower incomes and pre-existing medical conditions.

The share of adults age 50 to 64 who are at risk for high health care spending is rising, while the share with employer-sponsored health coverage is declining.

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Thirty percent of adults in this age group spend at least 10 percent of their disposable income on health care, compared to 18 percent among adults age 19 to 49. For those buying health insurance in the individual market, the likelihood of high total out-of-pocket health spending is much greater — three in four. The uninsured (8.9 million) outnumber those with public coverage (7.3 million) or those with other private coverage (4.2 million), and their number is growing. There are 3.7 million more uninsured older adults since 2000.

In "Health Insurance Coverage for 50- to 64-Year-Olds," AARP's Public Policy Institute examines sources of coverage for the 50 to 64 age group, issues confronting those not covered through an employer, characteristics of the uninsured, shifts in coverage with retirement, market trends, health care spending and the impact of the Affordable Care Act.

As the implementation of the Affordable Care Act proceeds, and debates about how to improve our health care system continue, it will be important to look at how well the system serves people who are most at risk in our current system, including adults age 50 to 64.

This report updates the 2009 health coverage report, "Health Care Reform: What’s at Stake for 50- to 64-Year-Olds."

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