this suggests that negative personal income shocks are likely to result in lower private health insurance coverage for instance in the united states most uninsured people attribute their lack of health coverage to the high cost of premiums oecd holahan and chen report that between and the number of us adults without health care coverage increased markedly because of rising poverty rates in addition to a drop in employersponsored plans the rise in adults without health coverage was concentrated among lowincome people as they could no longer afford to buy private health insurance