TL/DR –
The Commonwealth Fund’s 2023 Health Care Affordability Survey report showed that current health insurance coverage in the U.S. is insufficient, leading to worsening health conditions and rising medical debts among Americans. Specifically, half of all working-age adults with health insurance struggle to pay for health care and a third are carrying medical debt. In response to these findings, the report questioned the effectiveness of health insurance in the U.S. and highlighted the need for improvements in insurance coverage across all sources.
Unaffordable Health Care Costs and Rising Medical Debt in America
Recent data shows that American health insurance inadequately covers most care needs. The Commonwealth Fund survey reveals 50% of insured working adults struggle to meet health care costs, with a third burdened by medical debt.
Inadequate coverage results in worsening health, rising medical debt, and consumers delaying or altogether skipping necessary care. This challenges the belief that US health insurance ensures affordable access to care.
Health Insurance: A Double-Edged Sword?
While health insurance is better than none, according to researchers, even insured and healthy Americans can accrue medical debt and delay care. Lead researcher Sara R. Collins reported that insured, predominantly healthy Americans who postponed care due to costs experienced worsened health conditions. This was true regardless of whether coverage was employer-provided, through Medicare, Medicaid or obtained from the individual market or www.healthcare.gov.
Avoiding High Out-of-Pocket Costs
Xavier Becerra, Secretary of Health and Human Services, explained that the HHS has simplified finding health plans that offer comprehensive coverage and avoid high out-of-pocket costs for deductibles, coinsurance, and cost sharing.
Improvements to Health Care Plan Comparisons
Collins mentioned that the HHS added limits this year to simplify plan comparisons. Collins highlighted improvements such as tools to estimate total costs, including premiums and potential out-of-pocket costs. This feature should help consumers make more informed decisions and potentially minimize medical debt accumulation.
ACA’s Future and Survey Findings
The survey results question the proposition of replacing the ACA. Since its inception in 2014, ACA enrollment has consistently reached record highs, bolstered by improvements made by the Biden administration. Other findings from the survey include significant portions of insured adults finding it difficult to afford health care, insured adults delaying or skipping care due to cost, and health insurance failing to prevent the accrual of medical debt.
Resources
- Effectuated Enrollment: Early 2023 Snapshot and Full Year 2022 Average.
- State Fact Sheets: Impacts of the IRA and ACA on Lowering Health Care Costs.
- Geographic Variation in Health Insurance Coverage: United States, 2022, Terlizzi, Emily P.; Cohen, Robin A.; National Center for Health Statistics, published Nov. 9, 2023.
- Demographic Variation in Health Insurance Coverage: United States, 2022, Cohen, Robin A.;Terlizzi, Emily P.; National Center for Health Statistics, published Nov. 9, 2023.
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