Health insurance study: Even adults who are covered have trouble paying premiums, deductibles
Kevin Lyons
More and more adults with health insurance are skipping needed care and struggling to pay medical bills, a new study by The Commonwealth Fund shows.
In 2010, about 29 million American adults were underinsured, defined as those whose health insurance does not cover higher-dollar medical expenses. There were just 16 million such adults in 2003, or an increase of 80 percent.
The federal health care reform law seeks to bring relief to the underinsured through provisions that take effect through 2014.
Troubles include unfilled prescriptions
Until then, consumers and experts are dealing with some sad numbers. About 46 percent of underinsured adults didn’t fill a prescription or see a doctor when sick, or went without recommended treatment or medical tests, according to the study. Meanwhile, 52 percent of underinsured adults had trouble paying their medical bills, were contacted by a collections agency over an unpaid medical debt or had to change their way of life to pay medical bills.
“Underinsured families are at nearly as high risk as the uninsured because, while they have health insurance, holes or limits in their plans expose them to often unaffordable costs,” says Cathy Schoen, The Commonwealth Fund’s senior vice president and lead author of the report.
The Commonwealth Fund is a nonprofit foundation that studies health care reform issues.
In the study, a person whose family has out-of-pocket medical expenses (not including premiums) that are 10 percent or more of their income would be classified as underinsured.
Study offers sobering statistics
The study, drawing on the results of a telephone survey of 4,005 adults age 19 and older, also showed:
• Three-fourths of adults with annual incomes below $20,000 were either underinsured or uninsured.
• In 2010, nearly one of out of six adults who earned between $40,000 and $60,000 a year were underinsured, and nearly out of five of adults in that income bracket had no health insurance at all.
• One out of three underinsured adults reported annual deductibles of $1,000 or more, and nearly one in five adults said they spent 10 percent or more of their income on premiums.
Health care eats up family budgets
The disproportionate amount of money spent on health care can wreak havoc on the checkbooks of low- and middle-income Americans. According to the Kaiser Family Foundation, health insurance premiums for employer-backed plans have nearly doubled since 2000, from about $7,000 a year for a family plan to about $12,500 in 2010.
In a report sponsored by the U.S. Department of Health and Human Services, 37 percent of low-income adults and 22 percent of middle-income adults with employer-provided health insurance said they spent more than 10 percent of their salaries on health care, compared with 8 percent of high-income earners.
Under the federal health care reform law, lower-income families will get assistance with premiums, and a sliding scale for premiums will be available for middle-income families.
Karen Davis, president of The Commonwealth Fund, says that “in the future, families won’t have to live in fear of paying for health insurance that won’t protect them when sick — families, especially low- and middle-income families, will have the greater security of knowing they can afford the health care they need.”
