Of the current 326 million Americans, almost 90.9 percent have health insurance. Almost half of all Americans are covered through their or their spouse’s employer plan, while 33 percent have coverage through Medicaid or Medicare. Only about 7 percent get their health insurance through private insurers.
It would appear that most Americans are in a good position, at least from a health insurance perspective, but if you dig a little deeper, you will see that there are some serious problems with the current situation. In a recent poll, almost 44 percent of respondents said that they refused to see a doctor when sick or injured, primarily out of fear of the cost. About 40 percent said they avoided a test or treatment due to the cost.
What is surprising is that 86 percent of the poll’s respondents had health coverage—but were still concerned about the cost. This fear of medical bills seems to be greater than the fear of a serious medical condition. A poll by the West Health Institute revealed that 33 percent were very or extremely afraid of a serious illness, but 40 percent were more frightened of having to pay for treatment.
Why Is This Still a Problem?
In 2010, when President Barack Obama signed the Affordable Care Act into law, one of the most publicized justifications for this sweeping health care reform was that it would help keep in check rapidly rising health costs. By enrolling more people in Medicaid and private, subsidized health plans, fewer people should utilize expensive health care options like emergency rooms. Instead these people should get moderately priced care that heads off medical crises that could prove costly for the patient and providers.
The Affordable Care Act did help insure more than 20 million Americans from 2010 through 2017, but that didn’t stop health care prices from rising. Although health care cost inflation did slow following the ACA, in recent years, that inflation has surged. Since the passage of the Affordable Care Act through 2017, health care costs have kept below or at the level of overall inflation, but in 2018, health care cost inflation is at 2.2 percent, higher than the 1.9 general inflation rate.
Much of this surge in health care costs is due to increasing demand. Although the ACA did help rein in costs for a time, it also created a bigger consumer base for a health care system that has remained static or shrunk. This growing demand has allowed providers to raise prices without any financial backlash.
There are also some broad economic factors that are coming in to play. The low level of unemployment has led to increases in wages. This is likely to push up the cost of goods and services across all markets, including the health care sector.
Although nine in ten Americans have health insurance, more than 28 percent have less health coverage than they should. Of the under insured, almost 52 percent have problems paying medical bills and 45 percent skip doctor visits due to cost.
The Problem for the Under Insured
Almost 41 million Americans have some health coverage but are still vulnerable to financial problems related to medical bills. For most of these people, the most troubling aspects of their health coverage are the high annual deductibles or out-of-pocket expenses on their health plans. These under insured must devote five percent of their income if they are low-income households, or ten percent if they are middle or higher income families to covering medical expenses.
For most of these under insured households, the primary reason why they lack sufficient health coverage is that their employer has cut back on contributions to their employee plan. That means that workers have a greater responsibility for paying for their health coverage. Most employers are still paying about 70 percent of employee health plan premiums, but more companies are switching to high deductible plans which are cheaper.
More of the business world is transitioning to higher deductible employee health plans that cost on average $4,400 for employees every year. In 2009, only about 8 percent of U.S. workers were enrolled in high deductible health plans, but by 2016, this figure had grown to almost 29 percent. Much of this change has been fueled by rapid rise in health care costs that employers are unwilling to shoulder.
Even many households that get their health insurance independently of their employer have chosen high deductible health plans. One survey found that 37 percent of respondents had plans with higher deductibles. Almost 45 percent of these chose these plans because they cost less in monthly premiums.
However, most high deductible plans cost more for policyholders despite the lower up front costs. One study found that 62 percent of people with low premium/high deductible plans actually paid more for medical products and services than on a previous health plan. This is due to the fact that they must pay a larger proportion of any expenses, and they are responsible for all of the costs until the annual deductible threshold is reached.
Benefits of Robust Coverage
If you want to protect your family from a medical emergency and all of the financial repercussions that go along with them, then you should closely examine your current policy. If you find yourself responsible for most of the medical expenses during the year, then you should consider changing your health plan or taking out a supplemental health insurance policy. A supplemental policy will help cover many of the expenses that your current plan may not, including the annual deductible, copayments, and other out-of-pocket fees.
Having a more comprehensive insurance policy will not only protect you from a catastrophic medical emergency, but it will also help bring down your costs throughout the year whether they are for prescription medications, doctor’s visits or hospital stays.
If you would like an independent review of your current health insurance policy, please visit Boost Health Insurance.