Health Insurance Does Not Equal Affordability or Care

By Rosana Garcia

ACA_HRMSurvey-Urban-Report_landing-page-graphicTwo new reports confirm that affordability is still a concern, even for those with health insurance.

Families USA and the Kaiser Family Foundation both released reports about people enrolled in non-group plans (The Commonwealth Fund has a similar report). Non-group plans include all individual plans—those sold on the state exchange and in the individual market.

These types of plans are initially attractive—the monthly premium is low, and fits in with a person’s budget.  But when it comes time to use the health insurance plan, high deductibles and out of pocket costs prevent people from getting care.

This is known as underinsurance—when someone has a health insurance plan, but upfront costs deter people from getting the care they need.  People may not get necessary tests done or fill needed prescriptions.

As Wendell Potter pointed out in a recent blog discussing the Families USA Report: “ever-increasing numbers of Americans are finding themselves in the ranks of the underinsured.”

Drew Altman comments on the similar findings in a Kaiser Family Foundation report: “…The survey found that choosing a plan with a very high deductible can feel like a Faustian bargain if deductibles bite when people do need care. Deductibles, like all forms of cost-sharing, help keep health-care use and costs down, but finding the right balance between appropriate and excessive cost-sharing has become a major challenge for employers, insurers, the government, and consumers.”

This is a troubling trend—the promise of health insurance fades away for some when they need it most.  We all deserve better.

FAMILIES USA: Non-Group Health Insurance: Many Insured Americans with High Out-of-Pocket Costs Forgo Needed Health Care

WENDELL POTTER BLOG: Insurers’ High-Deductible Plans Leave Many Without Needed Care (references Families USA Report)

KAISER HEALTH NEWS: Survey of Non-Group Health Insurance Enrollees, Wave 2

DREW ALTMAN @ WSJ: The ‘Value’ Trade-Off in High-Deductible Health Plans (references Kaiser Family Foundation Report)

COMMONWEALTH FUND: The Problem of Underinsurance and How Rising Deductibles Will Make It Worse

VOX: Health insurance plans are getting crummier, and these charts prove it (references Commonwealth Fund Report)

FISCAL TIMES: Obamacare’s Direty Secret: 31 Million Still Can’t Afford Treatment (references Commonwealth Fund Report)

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