Monday, December 1, 2014

Prevalence of underinsurance unimproved and likely worse under ACA

November 28, 2014
Cost Still a Barrier Between Americans and Medical Care
By Rebecca Riffkin

One in three Americans say they have put off getting medical treatment
that they or their family members need because of cost. Although this
percentage is in line with the roughly 30% figures seen in recent years,
it is among the highest readings in the 14-year history of Gallup asking
the question.

Last year, many hoped that the opening of the government healthcare
exchanges and the resulting increase in the number of Americans with
health insurance would enable more people to seek medical treatment.
But, despite a drop in the uninsured rate, a slightly higher percentage
of Americans than in previous years report having put off medical
treatment, suggesting that the Affordable Care Act has not immediately
affected this measure.

The percentage of Americans with private health insurance who report
putting off medical treatment because of cost has increased from 25% in
2013 to 34% in 2014.

This year, 22% of Americans say they have put off medical treatment for
a "very" or "somewhat serious" condition.

Bottom Line

One of the goals of opening the government exchanges was to enable more
Americans to get health insurance to help cover the costs of needed
medical treatments. While many Americans have gained insurance, there
has been no downturn in the percentage who say they have had to put off
needed medical treatment because of cost.


The New York Times
December 1, 2014
Underinsurance Remains Big Problem Under Obama Health Law
By Aaron E. Carroll

The A.C.A. has not done as much as many had hoped it would to reduce
underinsurance. In fact, it may be helping to spread it. And proposed
modifications to the law, like those that would introduce a new tier of
"copper" plans in addition to bronze, silver, gold and platinum, might
make underinsurance worse.

The point of having insurance is to be able to get care when you need
it, without too large a financial burden. Underinsured Americans are not
receiving this benefit, though. They can't get the care they need.
Twenty-seven percent of adults with a deductible large enough to render
them underinsured didn't see the doctor when they were sick; 23 percent
didn't get a preventive care test; 29 percent skipped a test, treatment
or follow-up appointment; and 22 percent didn't see a specialist to whom
they were referred. Forty percent of them had at least one of these
cost-related access problems.

These are people who had private health insurance for the full year.
They are not the uninsured.

In the quest for universal coverage, it's important that we not lose
sight of "coverage" in order to achieve "universal." The point of
improving access is, after all, to make sure that people can get, and
afford, care when they need it.


Comment by Don McCanne

Health care reform should have eliminated underinsurance, not create
more of it. The private insurance industry will not fix this problem but
only compound it as it strives to keep its premiums competitive.

We need to replace the private insurers with our own single payer
program. For some, Medicare is also underinsurance. We need to fix that
and then provide it to everyone.

(Posted as a comment on the NYT website as a response to Aaron Carroll's

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