Nearly a Quarter of Consumers with Employer Coverage are Underinsured
By Consumers for Quality Care, on December 11, 2024
Many with health insurance through their work are still vulnerable to enormous out-of-pocket costs, according to a study conducted by the Commonwealth Fund and reported by Fierce Healthcare. These unexpected expenses could send consumers into medical debt, as well as force others to skip or delay seeking medical treatment for fear of incurring medical bills.
The study found that 23 percent of participants were underinsured. Of those underinsured, two-thirds had health insurance through their employer.
Sarah Collins, the co-author of the study and Vice President at the Commonwealth Fund, said that underinsurance is defined by the amount of out-of-pocket expenses consumers are susceptible to, such as deductibles, not by how expensive their monthly premium costs are. In addition to paying their premiums, many consumers must put up thousands of dollars each year before their health insurance covers their care.
Nearly half of underinsured individuals with medical debt owed at least $2,000, and 20 percent owed $5,000 or more.
Underinsured consumers can’t access the affordable care they need, as the cost makes up a large percentage of their household income. The study found that consumers with low income and with health problems were more likely to be underinsured. These consumers are more likely to avoid seeking medical care because of the cost.
The researchers behind the study propose several measures to make health care more affordable, including lowering deductibles, enhancing protections against medical debt, and making premium tax credits for ACA marketplace plans permanent.
Having insurance is not enough. CQC urges lawmakers and insurers to find solutions to deliver affordable health care for Americans and prevent consumers from going into medical debt for seeking care.
