An Unhealthy Trend

75 million adults — that’s 42% of working age adults in the US — had no insurance or really bad insurance (the kind that makes you pay up the nose anytime you sneeze) in 2007.

That’s up from 35% of working age adults that were uninsured or underinsured in 2003, the first time Health Affairs did this analysis. A new analysis — out today!– updates the study from five years ago.

Among the findings:

  • 25 million people who were technically “insured” actually have really crappy insurance (that amounts to one-fifth of the entire “insured” population)
  • The number of adults earning between $40k and $60k who were underinsured nearly tripled from 5% to 13%.
  • The number of adults earning more than $100k and were underinsured (meaning that they spent more than 10% of their income on out-of-pocket medical expenses) increased from 1% to 7%.

The series of studies is important because until recently, most analyses only tracked the number of people without coverage and how lack of coverage impacts a person’s ability to stay healthy. Just as important now, though, is this tracking the number of people with inadequate insurance. High deductibles, high co-pays, high co-insurance and high out-of-pocket costs cause patients to behave in similar ways to a person who is uninsured — they forgo care because of the expense.

Insurance companies like to argue that these low-quality, low-premium plans are at least a backstop to keep people from going into bankruptcy. But as our previous study has shown, people don’t have much in the way of assets — and a $5,000 deductible would wipe out the savings of 40% of Americans. Health Affairs (obviously a nerd’s must-read publication) also recently published a study that showed uninsured families earning more than 300% of the poverty level had less than $4,000 in liquid assets. (Here’s our blog post on that study).
From our perspective, being underinsured means you’re paying premiums to be functionally uninsured. All in all, we don’t really buy the insurance company logic on this and think they should be labeled and limited (and the most egregious ones banned) — as SB 1522 would do.

Health Access California promotes quality, affordable health care for all Californians.

Leave a Comment

%d bloggers like this: