qotd: ACA-compliant plans not providing adequate financial protection

Urban Institute
December 2015
How Much Do Marketplace and Other Nongroup Enrollees TSpend on Health
Care Relative to Their Incomes?
By Linda J. Blumberg, John Holahan, and Matthew Buettgens

In this paper, we examine premiums and out-of-pocket costs, as well as
total financial burdens for individuals with different characteristics
enrolled in ACA-compliant nongroup coverage. We show that despite the
additional assistance available, individuals across the income
distribution who are ineligible for Medicaid can still face very high
expenditures. At the median, financial burdens can be reasonably high,
particularly for those with incomes between 300 and 400 percent of FPL
(Figure 1). As medical care needs increase, however, financial burdens
grow appreciably across the income distribution. Even with federal
financial assistance, 10 percent of 2016 nongroup marketplace enrollees
with incomes below 200 percent of FPL will pay at least 18.5 percent of
their income toward premiums and out-of-pocket medical costs. Ten
percent of marketplace enrollees with incomes between 200 and 500
percent of FPL will spend more than 21 percent of their income on health
care costs. Those in fair or poor health and those over age 45 are most
likely to face high median financial burdens.

http://www.urban.org/sites/default/files/alfresco/publication-pdfs/2000559-How-Much-Do-Marketplace-and-Other-Nongroup-Enrollees-Spend-on-Health-Care-Relative-to-Their-Incomes.pdf

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Comment by Don McCanne

This is just one more study that shows that far too many individuals who
need health care still face excessive financial burdens in spite of
being insured. Instead of merely trying to tweak our dysfunctional
system, we should go ahead and replace it with one that works - a single
payer national health program.