Though it is much more than this, a family can be thought of as a collection of individuals that is grouped into a single financial unit sharing both resources and risks. In this sense, health insurance coverage can be viewed as a shared family resource. It is often obtained through the employment of a single member of the family, but it reflects a shared resource in other ways as well. When individuals in a family obtain coverage through means-tested government programs, their eligibility often depends on the combined income of the family unit. Conversely, the risk that out-of-pocket health care expenditures will severely strain a family’s finances can be seen as a shared family risk. So can a family’s decision about how many of its members to cover if employment-related family health care coverage is available to a member of the family.

This chapter examines the impact of health care expenses on the finances of families where one or more of the members are not covered by employer-provided or publicly provided health insurance. It first offers a picture of the typical financial position of such families—their income, assets, and borrowing capacity. Then it examines their health care expenditures. Next, the ways in which they meet these expenditures and the burden this imposes on family finances are explored. The chapter ends with a brief summary.