Having health insurance is not only too often tied to having a full-time job, it also usually requires that you be in that job for weeks or months before coverage kicks in. So with so many Americans either without staff jobs or starting work for a new employer, it’s perhaps not surprising that a new study claims that 26% of working-age people in the U.S. went without coverage at some point in 2011.

The study, released by the Commonwealth Fund, looked at lapses in health care coverage for Americans between the ages of 19 and 64, and concluded that approximately 48 million people in that age range experienced a gap in their health insurance last year.

Of those, 69% had gone at least one year without any health insurance, while 57% went uninsured for two years or more.

Of the people whose benefits had previously been provided by their employers, 67% cited a loss or change of a job as the primary reason for losing coverage.

People also ran up against ever-increasing rates for private health insurance. 62% of respondents who tried to buy individual policies in the past three years found it “very difficult or impossible” to locate affordable coverage. 31% of individual policy-seekers were turned down, charged a higher price, or had a condition excluded because of a pre-existing condition. And 45% said they opted to not purchase a policy, mainly because of cost.

The study also confirmed the relationship between having coverage and regular doctor visits, as 92% of working-age adults with continuous health insurance reported having a regular doctor, while only 76% of those with up to one year of an insurance gap could say the same. And for people with coverage gaps of two years or greater, only 46% said they were seeing a physician.

There was an even bigger difference when the study looked at specific treatments. For example, 74% of insured women between the ages of 40 and 64 had received a mammogram in the past two years. That number sunk all the way to 28% for women in the same age group who had gone without insurance for at least a year.

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