A nonprofit publication of the Kentucky Center for Public Service Journalism

Study finds more than 1/4 of adults in the U.S. are under-insured because of high deductibles

By Melissa Patrick
Kentucky Health News

More than one-fourth of U.S. adults with health insurance were under-insured in 2016, including 44 percent who got their coverage from the federal marketplace and almost 25 percent who got their coverage from employer plans, according to a recent study.

Using data from The Commonwealth Fund’s 2016 Biennial Health Insurance Survey, a report from the fund found that of all working-age adults who had health insurance for a full year in 2016, 28 percent, or about 41 million people, were underinsured.

This was up from 23 percent in 2014 and 12 percent in 2003, the first year the survey asked questions on the topic.

People in the study were considered underinsured if they had health insurance plans with high deductibles and high out-of-pocket expenses relative to their income.

More than half of the under-insured in the survey said they had trouble paying their medical bills, and 45 percent said they went without needed care because of cost.

“People who are under-insured face problems affording health care at rates similar to those seen for people with no health insurance at all, and they are almost as likely to skip needed care and to end up in debt when they get sick,” Sara Collins, lead author of the study, said in a news release.

A 2016 Kentucky Health Issues Poll found that nearly one-third of Kentucky adults, whether they had health insurance or not, struggled to pay their medical bills, and one-fifth said they often delayed or skipped needed medical care because of cost.

The Commonwealth Fund’s national report says the added cost burden that comes with high-deductible plans, which have become the norm, has created a steady increase in the rates of under-insured people.

In 2016, the study found that 13 percent of adults enrolled in a private plan had a deductible of $3,000 or more, up from just 1 percent in 2003. It added that only 22 percent of private insurance plans offered plans with no deductibles in 2016, down from 40 percent in 2003.

And the deductibles are even higher in the individual marketplace. “Twenty-three percent of adults with individual and marketplace plans had plan deductibles equaling 5 percent or more of income,” says the report.

For example, the least expensive 2017 “silver” plan that popped up on Healthcare.gov for a Kentucky family of four making around $75,000 a year requires a $548 monthly premium (after applying the $441 per month premium tax credit) and a $12,300 deductible. It also required a $30 co-payment for every visit to the primary-care provider, with a $14,000 out-of-pocket family maximum.

The survey also found that about half of the under-insured adults who had problems paying their medical bills or had medical debt said they had used up all their savings to pay their bills, with 40 percent of them saying they now have a lower credit rating because of their bills.

This should come as no surprise. A 2017 GOBankingRates survey found that more than half of Americans (57 percent) said they have less than $1,000 in their savings accounts and 39 percent of them had no savings at all. A separate survey found that 49 percent of all Americans live paycheck-to-paycheck.

The authors say that extending the federal cost-sharing reduction payments to more enrollees, excluding more services from plan deductibles, and increasing the required minimum value of employer plans, along with addressing rising health-care costs, are possible ways to make health insurance more affordable.

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