Nearly a quarter of all people who bought Obamacare health plans still cannot afford the care they need, a leading advocate for President Obama’s healthcare law says.
Families USA, a group that often proposes improvements to the law, says high deductibles make healthcare unaffordable for many people, even though they now have insurance.
A survey released by the group Thursday found that nearly one in four adults shopping in the new insurance marketplaces bought plans with deductibles of $3,000 or more and 42 percent enrolled in plans with at least a $1,500 deductible.
It means many customers are forgoing needed health services because they cannot foot the bill.
“They could not afford tests or they could not afford various treatments or they could not afford the cost of medicines,” said Families USA President Ron Pollack. “The key culprit [is] high deductibles.”
A deductible is a sum the consumer must pay before benefits kick in, in addition to the monthly premium. While many people tend to pick a plan based on the premium cost, a plan’s deductible can add on considerable expense, even if the purchaser qualifies for government assistance.
While the insurance exchanges and the federal subsidies offered through them have helped millions of people gain health insurance, concern remain that plans cost to much and fall short of new coverage requirements.
A person earning $30,000 who buys a middle-grade “silver” plan on the exchange has to pay a premium of about $2,350 after federal subsidies are applied. Add a $3,000 deductible and suddenly their insurance could cost more than 18 percent of their income. This prompts some people with insurance to skip care to avoid out-of-pocket costs.
The Families USA survey found that one fourth of those insured on the individual market, both inside and outside the exchanges, went without needed medical care because they could not afford it. Fifteen percent skipped needed tests or follow-up care and 14 percent went without needed medicines.
Insurers are thought to have raised deductibles to keep premium costs down, as Obamacare required them to cover more services, some without additional cost to customers.
The group is pressing insurers to tamp down deductibles, saying they can easily lighten the load on consumers, especially those with low incomes, who tend to buy coverage on the exchanges.
“Insurers in every state need to be selling plans that have lower up-front cost-sharing,” said Lydia Mitts, senior policy analyst at Families USA. “They have the ability to do that.”
Now that the Affordable Care Act’s second enrollment season has wrapped up, with nearly 11.7 million people signing up for coverage in the state-based marketplaces, health advocates have recently drawn attention to changes they’d like to see.
Women’s groups have called attention to how insurers aren’t fully complying with the law’s mandate to cover birth control. Others have asked the administration to allow pregnant women to enroll in exchange plans year-round.
