Finding and purchasing affordable individual health insurance coverage in the past few years has become increasingly complicated, according to a new study.

A report released this week by advocacy group the Commonwealth Fund found that 71% of an estimated 26 million people who tried to buy individual health insurance over the past three years had complications of some kind. Of this group, 35% were turned down or charged higher prices because of their medical history or pre-existing conditions. The survey also found that nearly 52 million people in the U.S. went without medical coverage for some or all of 2010, compared to 38 million people in 2001.

Sara Collins, vice president for Commonwealth’s Program on Affordable Health Insurance, said what was most surprising in the study was that so many people who had lost a job in the past two years did not get new coverage through COBRA or elsewhere. The report found that of the 43 million adults who lost jobs in the past two years, nine million became uninsured.

“It really demonstrates how difficult it is to afford coverage on their own,” Collins said. “People are really feeling the pressures of rising cost.”

Under the health care reform act, people would have access to insurance either through Medicaid or subsidized premiums, she said.

“It really is a major difference in terms of options for people when they either lose a job, or are in an economic downturn,” Collins said. “We won’t see these large numbers of people who are uninsured.”

Collins said one of the most important things the study highlights is that people want to be covered. Most of the nine million people who were left uninsured due to layoffs in 2009 and 2010 didn’t do so by choice. Collins said that affordability and access are the main roadblocks that stop people from obtaining coverage.

More than 43% of people who tried to find individual coverage found it very difficult or impossible to find a plan that fit their needs, and 16 million adults looking for individual coverage found it very difficult or impossible to find a plan they could afford.

“It’s not as if they are being carefree or blasé,” she said. “They tend to want it, and people really do face barriers when they try to buy it. They are aware that if you are caught without it, you are at serious financial risk.”

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