Many younger vets among the ranks of uninsured

McClatchy NewspapersNovember 19, 2012 

— More than quarter of all veterans who served in Iraq and Afghanistan don’t have health insurance and aren’t part of the Department of Veterans Affairs health system, according to an analysis of VA data.

The uninsured rate among these recent veterans is higher than for other war periods and for veterans as a whole, raising concerns that veterans recently back from the wars might not be taking advantage of care to which they are entitled.

Veterans advocates and some lawmakers have pushed to automatically enroll veterans in the VA health care system, which could fill in the gap for some of the veterans not now covered by the VA or the private market.

“It is critically important that we continue to reach out and inform veterans of the health care and benefits they have earned through their service to country,” said VA spokesman Josh Taylor. “We have made progress, but there is more work to do.”

The numbers are from the 2010 National Survey of Veterans, conducted by the VA periodically to determine the state of America’s veteran population.

Veterans who have left combat operations from the recent wars are eligible for VA health care for five years and after that must qualify based on the disability- or income-based standards. While some veterans can use the VA health system for life, most don’t; of 22 million veterans, 8.6 million are part of the VA’s system, 2011 numbers show.

That’s a surprise to many people, who assume all veterans qualify for the VA’s network of hospitals and clinics, said Steffie Woolhandler, a researcher who has tracked veteran health insurance status.

“I’m quite sure that most doctors believe that vets have health insurance, because they generally express surprise when I present my work on vets at meetings and in medical journals,” said Woolhandler, a professor of public health at City University of New York and a visiting professor at Harvard Medical School. “I’m pretty sure most of the lay public thinks so, too.”

McClatchy analyzed the 2010 national survey, categorizing veterans by their most recent period of service. Of those who indicated they served in the recent wars, 26 percent said they neither had health insurance nor were part of the VA health system. For veterans from previous periods – the 1990s, including the first Persian Gulf War; Vietnam; and peacetime periods – the comparable percentage uninsured was between 10 percent and 16 percent.

Veterans from World War II or the Korean War are old enough to qualify for Medicare, and their uninsured rate was less than 2 percent.

Lack of insurance can be a significant problem. Woolhandler’s research found that uninsured veterans are five times more likely to need but not get medical care than are insured veterans, and they are four times more likely to delay care because of cost. Nearly half of uninsured vets said they had “no place to go when sick,” according to her 2007 research.

Young people in general are less likely to have insurance than middle age or older Americans. They have lower incomes and less secure jobs; some choose to skip the expense, figuring they are healthy enough to get by.

But veterans have health issues that deserve special attention, said Rep. Bill Owens, D-N.Y., who has introduced legislation that would automatically enroll returning service members into the VA health care system rather than requiring they seek out the VA.

“Many of these folks suffer from post-traumatic stress disorder or traumatic brain injuries,” Owens said. “Unless they have someone who is able to work with them, I think a lot of them slip through the cracks. We’re trying to avoid that slippage.”

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