The president’s healthcare law sliced America’s uninsured rate down to historic lows by expanding coverage for tens of millions of Americans. At the same time, however, the number of insured people who still lack affordable, robust coverage is rising sharply as more people buy into high-deductible policies.
A new study from the Commonwealth Fund reveals that about 23 percent of Americans with coverage are considered underinsured—up from 12 percent in 2003. That means roughly 31 million Americans who bought health insurance still have trouble affording treatment under their policies.
The researchers at the Commonwealth Fund defined “underinsured” people as having out-of-pocket costs that total 10 percent or more of their annual income, or a deductible that is 5 percent or more of their income. The study concluded that high-deductible policies are likely the culprit behind this massive influx of underinsured people.
The findings are a huge problem for the Obama administration since the entire goal was to expand access to coverage to millions of Americans that they presumably would use instead of delaying treatment. But a handful of recent studies show that even people with health insurance are delaying treatment because they can’t afford it.
A December Gallup Poll showed at least 38 percent of insured, middle-income people, said they had delayed medical treatment because of the cost. “While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost,” Gallup’s Rebecca Riffkin wrote in a post on the pollster’s website.
The shift toward cost-sharing and high-deductible policies—defined by the Internal Revenue Service as those with annual deductibles of $1,300 or more for individuals and $2,600 for families--is widespread among exchange policies but also employer plans.
The Commonwealth Foundation’s study, unsurprisingly, reveals that low-income people with coverage are about twice as likely to be “underinsured” than people earning more than 200 percent of the poverty line.
Of course, it’s important to note that while affordability continues to be an issue, significantly more people do have health insurance because of the law.
Democratic presidential candidates are proposing a variety of new taxes to pay for their preferred social programs. Bloomberg’s Laura Davison and Misyrlena Egkolfopoulou took a look at how the top four candidates would fare under their own tax proposals.
“The fact is very little medical care is shoppable. We become good shoppers when we are repeat shoppers. If you buy a new car every three years, you can become an informed shopper. There is no way to become an informed shopper for your appendix. You only get your appendix out once.”
— David Newman, former director of the Health Care Cost Institute, quoted in an article Thursday by Noam Levey of the Los Angeles Times. Levey says the “consumer revolution” in health care – in which patients shop around for the best prices, forcing doctors, hospitals and pharmaceutical firms to compete with lower prices – hasn’t materialized, but the higher deductibles that were part of the effort are very much in effect. “High-deductible health insurance was supposed to make American patients into smart shoppers,” Levey writes. “Instead, they got stuck with medical bills they can't afford.”
The House Ways and Means Committee released a new analysis of drug prices in the U.S. compared to 11 other developed nations, and the results, though predictable, aren’t pretty. Here are the key findings from the report:
- The U.S. pays the most for drugs, though prices varied widely.
- U.S. drug prices were nearly four times higher than average prices compared to similar countries.
- U.S. consumers pay significantly more for drugs than other countries, even when accounting for rebates.
- The U.S. could save $49 billion annually on Medicare Part D alone by using average drug prices for comparator countries.
The U.S. ranks 18th for retiree well-being among developed nations, according to the latest Global Retirement Index from Natixis, the French corporate and investment bank. The U.S. fell two spots in the ranking this year, due in part to rising economic inequality and poor performance for life expectancy.