One in eight veterans under 65 is uninsured, study finds

By Elizabeth Cooney, Globe Correspondent

Most Americans might think that veterans automatically have healthcare from the government, but one in eight working-age veterans is uninsured, a study from Cambridge Health Alliance reports.

Healthcare at Veterans Health Administration hospitals and clinics is limited to veterans who have service-related conditions or who have incomes of less than about $30,000 a year, depending on where they live. That leaves many middle-income veterans under 65 without coverage of any kind, mirroring the situation of other uninsured groups, Dr. Steffie Woolhandler, author of the study in the American Journal of Public Health, said in an interview.

“I and I think a majority of Americans had assumed that all veterans were automatically eligible for healthcare, and this in fact was true in the late 1990s,” she said. Now “the majority of middle-income veterans are excluded.”

A 1996 law opened VA care to all veterans, with a $50 co-pay for those were not classified as poor. But in 2002, regional directors were told not to market enrollment to new veterans because demand was exceeding resources, according to a department memo quoted in the journal article. Then in 2003, enrollment was halted for most veterans without qualifying medical conditions or incomes.

Using government data, Woolhandler and her co-authors found 1.8 million veterans who were uninsured and not receiving VA care in 2004, the most recent year available. That represented an increase of 290,000 since 2000. They also identified 3.8 million family members of those veterans who also had no health insurance. Together they account for 12.2 percent of the 47 million uninsured people in the United States.

“This really epitomizes the uninsured in the United States. They are working-age families earning too little to be able to afford to buy health insurance but too much to qualify for Medicaid,” she said.

The typical uninsured veteran is a 45-year-old man who has worked in the past year and is earning from $30,000 to $40,000 a year, Woolhandler said.

“Our soldiers serve so we don’t have to. They’re serving and protecting us,” she said. “They’re holding up their part of the bargain and when they come home, we’re really saying we as a society don’t have any obligation to serve and protect them by providing healthcare.”