Coverage Gaps, Uninsurance Tied to Unmet Vision Care Needs

Health insurance coverage gaps and uninsurance were associated with a higher risk of unmet vision care needs among adults in Ohio, indicating the importance of continuous coverage, a study published in JAMA Ophthalmology found.

Around 93 million people in the United States are at risk of vision loss, only half of whom have seen a vision care professional in the past year. Health insurance coverage is an important factor when it comes to accessing vision care.

Researchers used data from the 2021 Ohio Medicaid Assessment Survey (OMAS) to determine if recent gaps in health insurance coverage were associated with an increased risk of unmet need for vision care among adults in Ohio.

The sample included 19,036 adults who stated they had vision care needs in the past year. Researchers considered adults to have unmet care needs if they said they could not get the vision care or eyeglasses they needed within the last year.

The study found that 4 percent of adults experienced recent coverage gaps, while another 4 percent were uninsured for the whole year. Thirteen percent of adults reported unmet needs for vision care, translating to a weighted 590,015 adults. Unmet vision care needs were more common among adults with coverage gaps (27 percent) and those with year-round uninsurance (47 percent) compared to adults with year-round private coverage (8 percent) and year-round public coverage (21 percent).

Coverage gaps may be tied to unmet vision care needs if people switch to a plan with limited or no vision coverage or if they have to find a different provider that accepts their new plan. In addition, social stressors like job loss can lead to coverage loss and impede access to care.

Adults with visual impairment history are twice as likely to report medical costs as a barrier to vision care and are less likely to have health insurance coverage compared to those without a visual impairment, researchers noted.

“Together with our data, these findings reveal the risk of a self-reinforcing cycle where socioeconomic disadvantage coincides with visual impairment and limits its effective treatment,” the study stated.

Continuous access to health insurance coverage is essential for improving access to vision care. Expanding income eligibility for Medicaid and providing continuous eligibility could help ensure access to public coverage.

Additionally, expanding the range of ophthalmic conditions that allow individuals to qualify for Medicare based on legal disability could help secure coverage for adults with significant vision impairment of ophthalmic disease.

Reducing administrative barriers to enrollment in public and private plans could also help minimize coverage gaps.