Although it is a fact that a greater number of Americans are now on some form of healthcare insurance coverage, the bigger picture is hardly as rosy. The situation can be best described as one where quality has been compromised over quantity, meaning that although more people have insurance, they just don’t have enough of it. Many insurance options available to people don’t cover even the most basic medical needs.
The statistics are not providing a better picture either. According to researchers, the year 2018 saw around 45% of adults in the working age bracket to be underinsured with some not having any kind of insurance at all (at least temporarily during the year). That’s 87 million people right there, people who had to suffer from uncertainty stemming from not having adequate insurance cover.
It is interesting to note that this trend in health insurance has remained the same ever since 2010, a fact which might come as a shock to many considering the US healthcare policy has seen dramatic shifts in these years. For example, after the Affordable Care Act came into enactment back in 2010, with key provisions in force four years after that, 20 million Americans were brought into the insurance coverage net, mostly those who either did not have any form of insurance either from private sources or from an employer.
But the fact that millions of people finally have access to health insurance does not mean they are living stress-free when it comes to seeking medical help. In fact, many people avoid paying a visit to the doctor, even if they have insurance, simply because of the high out-of-pocket costs, and those who are unable to avoid such a visit must struggle with paying off the expenses over time.
Some More Statistics
According to the results of this study, it was found that the majority of Americans below the age of 65 were covered under health insurance schemes being offered by their employers. Of that age cohort, around a quarter opted for other options like Medicaid or insurance packages available in the marketplace. However, back in 2014 those who were covered under some form of insurance, 23% said that they were underinsured. This percentage has gone up to 29% in 2018.
But that’s not the most alarming. As part of the same study, respondents who had reported being underinsured were asked to report the frequency with which they were seeking care. 41% of all respondents revealed that they had postponed seeking care at some point during the year, 23% had not sought care at all even though they needed it, and 25% revealed that financing the medical bills was a point of concern for them.
What’s Causing This?
Although it is easier to assume that the blame rests with the ACA since it was after its enactment that insurance coverage became affordable for a greater number of people, but that is not why people have become underinsured. According to this study, the real culprit is the employer-based plans. Due to the rising costs of healthcare in the US, employers have been shifting the burden on the employees by asking them to pay higher premium costs or offering plans which come with much higher deductibles than before.
Even though the proportion of people who are underinsured stands at 42% in the case of those with individual plans and 28% with employer-based plans, if growth rates are compared between the two categories from 2010 to 2018, the people on employer-based plans have increasingly become more underinsured over time compared to those on individual plans.
What’s the Solution?
There have been efforts to bring more people on employer-based coverage plans, but considering the statistics above, that is clearly not the solution. Employer-based plans are slowly becoming increasingly inadequate at providing coverage to people, which means that other measures must be taken by policymakers, such as reducing the overall healthcare costs which are impacting the entire healthcare industry, including insurance costs.