Why Insurance Doesn’t Always Prevent Giant Medical Bills

The New York Times by Margot Sanger-Katz

Adults Struggling with Medical BillsHealth insurance is supposed to help you pay for your health care, but it’s also supposed to protect you from financial ruin. A large new survey finds that, for nearly a quarter of insured adults, insurance has provided flimsy protection against huge medical bills.

The survey, from the health research group the Commonwealth Fund, looked at around 3,000 adults who had been insured all year, and found that in 2014, 23 percent of them were “underinsured,” according to a definition of financial exposure developed by the researchers. The group in the study included people with Medicaid, Medicare and their own health insurance, but also the large percentage of Americans with insurance through their jobs.

Many recent changes in the health care system — good and bad — tend to get pinned on the Affordable Care Act. But the Commonwealth study shows that the proportion of insured people with substantial medical costs has been essentially unchanged since 2010, the year the health law passed. In 2010, 22 percent of insured people met the definition of underinsured. In 2014, when many of the law’s major provisions went into effect, that proportion was 23 percent.

The big change in the country’s experience of health insurance appears to have happened between 2005 and 2010; five years before Obamacare passed, only 13 percent of insured Americans met the fund’s definition of underinsured. Since then, the study shows, the number of adults expected to pay a certain amount (a deductible) for their medical care before insurance kicks in has increased. So has the size of those deductibles.

Read the full article here.