RESUMEN
ISSUE: The number of Americans insured by Medicaid has climbed to more than 70 million, with an estimated 12 million gaining coverage under the Affordable Care Act's Medicaid expansion. Still, some policymakers have questioned whether Medicaid coverage actually improves access to care, quality of care, or financial protection. GOALS: To compare the experiences of working-age adults who were either: covered all year by private employer or individual insurance; covered by Medicaid for the full year; or uninsured for some time during the year. METHOD: Analysis of the Commonwealth Fund Biennial Health Insurance Survey, 2016. FINDINGS AND CONCLUSIONS: The level of access to health care that Medicaid coverage provides is comparable to that afforded by private insurance. Adults with Medicaid coverage reported better care experiences than those who had been uninsured during the year. Medicaid enrollees have fewer problems paying medical bills than either the privately insured or the uninsured.
Asunto(s)
Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Medicaid/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Adulto , Financiación Personal , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Servicios Preventivos de Salud/estadística & datos numéricos , Sector Privado , Calidad de la Atención de Salud , Estados UnidosRESUMEN
ISSUE: The Affordable Care Act has significantly increased health insurance coverage and access to care among U.S. adults nationwide. However, the law gives states flexibility in implementing certain provisions, leading to wide variations between states in consumers' experiences. GOAL: To examine the differences in insurance coverage, access to care, and medical bill problems in the four largest statesCalifornia, Florida, New York, and Texasall of which have made different choices in implementing the law. METHODS: Analysis of the Commonwealth Fund Biennial Health Insurance Survey, 2016. FINDINGS AND CONCLUSIONS: In 2016, uninsured rates among adults ages 19 to 64 across the four states varied from 7 percent in New York and 10 percent in California to 16 percent in Florida and 25 percent in Texas. This variation was also apparent in the proportions of residents reporting problems getting needed care because of the costsignificantly lower in California and New York than in Florida and Texas. Lower percentages of Californians and New Yorkers reported having a medical bill problem in the past 12 months or having accrued medical debt compared to Floridians and Texans. These variations might be explained by several factors: whether the state expanded Medicaid eligibility; whether it ran its own health insurance marketplace; what the uninsured rate was prior to the Affordable Care Act; differences in the cost protections provided by private health plans; and demographic differences.
Asunto(s)
Financiación Personal/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Medicaid/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Adulto , California , Florida , Predicción , Encuestas Epidemiológicas , Humanos , Cobertura del Seguro/tendencias , Seguro de Salud/estadística & datos numéricos , Seguro de Salud/tendencias , Persona de Mediana Edad , New York , Patient Protection and Affordable Care Act , Texas , Estados UnidosRESUMEN
Issue: Since 2001, long before the passage of the Affordable Care Act (ACA), the Commonwealth Fund Biennial Health Insurance Survey has examined health coverage and consumers' experiences buying insurance and using health care. Goals: To examine long-term trends and to make comparisons before and after passage of health reform. Methods: Analysis of the Commonwealth Fund Biennial Health Insurance Survey, 2016. Findings and Conclusions: There have been dramatic improvements in people's ability to buy health plans on their own following the passage of the ACA. For adults with family incomes less than $48,500, uninsured rates dropped about 17 percentage points below their 2010 peak. Lower-income whites, blacks, and Latinos have experienced drops this large, though Latinos are uninsured at higher rates. Among working-age adults who had shopped for plans in the individual market and ACA marketplaces over the prior three years, the percentage who reported it was very difficult to find affordable plans fell by nearly half from 2010, prior to the ACA reforms, to 2016. Coverage gains are helping working-age Americans get the care they need: the number of adults who reported problems getting needed health care and filling prescriptions because of costs fell from a high of 80 million in 2012 to an estimated 63 million in 2016.
Asunto(s)
Cobertura del Seguro/legislación & jurisprudencia , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/legislación & jurisprudencia , Seguro de Salud/estadística & datos numéricos , Pacientes no Asegurados/legislación & jurisprudencia , Pacientes no Asegurados/estadística & datos numéricos , Patient Protection and Affordable Care Act/estadística & datos numéricos , Adulto , Empleo , Etnicidad , Financiación Personal/legislación & jurisprudencia , Financiación Personal/estadística & datos numéricos , Financiación Personal/tendencias , Reforma de la Atención de Salud/legislación & jurisprudencia , Reforma de la Atención de Salud/estadística & datos numéricos , Reforma de la Atención de Salud/tendencias , Encuestas de Atención de la Salud , Intercambios de Seguro Médico , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/tendencias , Estado de Salud , Humanos , Cobertura del Seguro/tendencias , Seguro de Salud/tendencias , Persona de Mediana Edad , Patient Protection and Affordable Care Act/tendencias , Atención Dirigida al Paciente/legislación & jurisprudencia , Atención Dirigida al Paciente/estadística & datos numéricos , Atención Dirigida al Paciente/tendencias , Pobreza , Servicios Preventivos de Salud/legislación & jurisprudencia , Servicios Preventivos de Salud/estadística & datos numéricos , Servicios Preventivos de Salud/tendencias , Grupos Raciales , Estados UnidosRESUMEN
Issue: Although predictions that the Affordable Care Act (ACA) would lead to reductions in employer-sponsored health coverage have not been realized, some of the law's critics maintain the ACA is nevertheless driving higher premium and deductible costs for businesses and their workers. Goal: To compare cost growth in employer-sponsored health insurance before and after 2010, when the ACA was enacted, and to compare changes in these costs relative to changes in workers' incomes. Methods: The authors analyzed federal Medical Expenditure Panel Survey data to compare cost trends over the 10-year period from 2006 to 2015. Key findings and conclusions: Compared to the five years leading up to the ACA, premium growth for single health insurance policies offered by employers slowed both in the nation overall and in 33 states and the District of Columbia. There has been a similar slowdown in growth in the amounts employees contribute to health plan costs. Yet many families feel pinched by their health care costs: despite a recent surge, income growth has not kept pace in many areas of the U.S. Employee contributions to premiums and deductibles amounted to 10.1 percent of U.S. median income in 2015, compared to 6.5 percent in 2006. These costs are higher relative to income in many southeastern and southern states, where incomes are below the national average.
Asunto(s)
Planes de Asistencia Médica para Empleados/economía , Planes de Asistencia Médica para Empleados/tendencias , Deducibles y Coseguros/economía , Deducibles y Coseguros/tendencias , Financiación Personal/economía , Financiación Personal/tendencias , Predicción , Humanos , Renta , Patient Protection and Affordable Care Act/economía , Estados UnidosRESUMEN
The number of uninsured people in the United States has declined by an estimated 20 million since the Affordable Care Act went into effect in 2010. Yet, an estimated 24 million people still lack health insurance. Goal: To examine the characteristics of the remaining uninsured adults and their reasons for not enrolling in marketplace plans or Medicaid. Methods: Analysis of the Commonwealth Fund ACA Tracking Survey, February--April 2016. Key findings and conclusions: There have been notable shifts in the demographic composition of the uninsured since the law's major coverage expansions went into effect in 2014. Latinos have become a growing share of the uninsured, rising from 29 percent in 2013 to 40 percent in 2016. Whites have become a declining share, falling from half the uninsured in 2013 to 41 percent in 2016. The uninsured are very poor: 39 percent of uninsured adults have incomes below the federal poverty level, twice the rate of their overall representation in the adult population. Of uninsured adults who are aware of the marketplaces or who have tried to enroll for coverage, the majority point to affordability concerns as a reason for not signing up.
Asunto(s)
Intercambios de Seguro Médico/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Adulto , Población Negra , Determinación de la Elegibilidad , Empleo , Femenino , Predicción , Intercambios de Seguro Médico/tendencias , Hispánicos o Latinos , Humanos , Cobertura del Seguro/tendencias , Masculino , Medicaid , Persona de Mediana Edad , Pobreza , Gobierno Estatal , Estados Unidos , Población Blanca , Adulto JovenRESUMEN
For people with low and moderate incomes, the Affordable Care Act's tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance. For those with higher incomes, the tax credits phase out, meaning that adults in marketplace plans on average have higher premium costs than those in employer plans. The law's cost-sharing reductions are reducing deductibles. Lower-income adults in marketplace plans were less likely than higher-income adults to report having deductibles of $1,000 or more. Majorities of new marketplace enrollees and those who have changed plans since they initially obtained marketplace coverage are satisfied with the doctors participating in their plans. Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill. This issue brief explores these and other findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.
Asunto(s)
Comportamiento del Consumidor/estadística & datos numéricos , Planes de Asistencia Médica para Empleados/economía , Planes de Asistencia Médica para Empleados/estadística & datos numéricos , Intercambios de Seguro Médico/economía , Intercambios de Seguro Médico/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/economía , Seguro de Salud/estadística & datos numéricos , Patient Protection and Affordable Care Act/economía , Patient Protection and Affordable Care Act/estadística & datos numéricos , Adulto , Seguro de Costos Compartidos/economía , Seguro de Costos Compartidos/estadística & datos numéricos , Deducibles y Coseguros/economía , Deducibles y Coseguros/estadística & datos numéricos , Demografía , Financiación Personal/economía , Financiación Personal/estadística & datos numéricos , Encuestas de Atención de la Salud , Humanos , Cobertura del Seguro/economía , Persona de Mediana Edad , Estados UnidosRESUMEN
The Affordable Care Act's premium subsidies and cost-sharing reductions have helped to reduce out-of-pocket costs for low-income people enrolled in marketplace plans. This financial protection has been particularly important for people with incomes above 100 percent of poverty who live in states that have not expanded Medicaid. However, a key question for policymakers is how this protection compares to Medicaid. This brief analyzes a sample of silver plans offered in the largest markets in 18 states that use the federal website for marketplace enrollment and have not expanded Medicaid eligibility. It finds that marketplace enrollees at this income level in most plans analyzed are at risk of incurring premium and out-of-pocket costs that are higher than what they would pay under Medicaid. For people with significant health needs, costs are estimated to be much higher in marketplace plans than what they would be under Medicaid.
Asunto(s)
Seguro de Costos Compartidos/economía , Seguro de Costos Compartidos/estadística & datos numéricos , Financiación Personal/economía , Financiación Personal/estadística & datos numéricos , Intercambios de Seguro Médico/economía , Intercambios de Seguro Médico/estadística & datos numéricos , Cobertura del Seguro/economía , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/economía , Seguro de Salud/estadística & datos numéricos , Medicaid/economía , Medicaid/estadística & datos numéricos , Humanos , Patient Protection and Affordable Care Act/economía , Pobreza , Gobierno Estatal , Estados UnidosRESUMEN
The fourth wave of the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016, finds at the close of the third open enrollment period that the working-age adult uninsured rate stands at 12.7 percent, statistically unchanged from 2015 but significantly lower than 2014 and 2013. Uninsured rates in the past three years have fallen most steeply for low-income adults though remain higher compared to wealthier adults. ACA marketplace and Medicaid coverage is helping to end long bouts without insurance, bridge gaps when employer insurance is lost, and improve access to health care. Sixty-one percent of enrollees who had used their insurance to get care said they would not have been able to afford or access it prior to enrolling. Doctor availability and appointment wait times are similar to those reported by insured Americans overall. Majorities with marketplace or Medicaid coverage continue to be satisfied with their insurance.
Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Medicaid/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Patient Protection and Affordable Care Act/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Etnicidad , Planes de Asistencia Médica para Empleados , Encuestas de Atención de la Salud , Intercambios de Seguro Médico , Accesibilidad a los Servicios de Salud/tendencias , Humanos , Cobertura del Seguro/tendencias , Seguro de Salud/tendencias , Persona de Mediana Edad , Patient Protection and Affordable Care Act/tendencias , Atención Primaria de Salud , Grupos Raciales , Estados Unidos , Listas de EsperaRESUMEN
Health insurers selling plans in the Affordable Care Act's marketplaces are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal poverty level. In 2016, as many as 7 million Americans may have plans with these cost-sharing reductions. In the largest markets in the 38 states using the federal website for marketplace enrollment, the cost-sharing reductions substantially lower projected out-of-pocket costs for people who qualify for them. However, the degree to which consumers' out-of-pocket spending will fall varies by plan and how much health care they use. This is because insurers use deductibles, out-of-pocket limits, and copayments in different combinations to lower cost-sharing for eligible enrollees. In 2017, marketplace insurers will have the option of offering standard plans, which may help simplify consumers' choices and lead to more equal cost-sharing.
Asunto(s)
Seguro de Costos Compartidos/economía , Gastos en Salud/estadística & datos numéricos , Patient Protection and Affordable Care Act/economía , Seguro de Costos Compartidos/legislación & jurisprudencia , Seguro de Costos Compartidos/métodos , Seguro de Costos Compartidos/normas , Deducibles y Coseguros/economía , Deducibles y Coseguros/estadística & datos numéricos , Intercambios de Seguro Médico , Humanos , Renta , Seguro de Salud , Pobreza , Estados UnidosRESUMEN
Issue: The Affordable Care Act's policy reforms sought to expand health insurance coverage and make health care more affordable. As the nation prepares for policy changes under a new administration, we assess recent gains and challenges. Goal: To compare access to affordable health care across the U.S. between 2013 and 2015. Methods: Analysis of most recent publicly available data from the U.S. Census Bureau and the Behavioral Risk Factor Surveillance System. Key findings and conclusions: Between 2013 and 2015, uninsured rates for adults ages 19 to 64 declined in all states and by at least 3 percentage points in 48 states and the District of Columbia. For children, uninsured rates declined by at least 2 percentage points in 28 states. The share of adults age 18 and older who reported forgoing a visit to the doctor when needed because of costs dropped by at least 2 percentage points in 38 states and D.C. In contrast, there was little progress in expanding access to dental care for adults, which is not a required benefit under the ACA. These findings illustrate the impact that policy can have on access to care and offer a focal point for assessing future policy changes.
Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Patient Protection and Affordable Care Act , Adolescente , Adulto , Negro o Afroamericano/estadística & datos numéricos , Niño , Preescolar , Predicción , Disparidades en Atención de Salud/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Cobertura del Seguro/tendencias , Persona de Mediana Edad , Pobreza , Gobierno Estatal , Estados Unidos , Población Blanca/estadística & datos numéricosRESUMEN
According to the most recent Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015, an estimated 25 million adults remain uninsured. To achieve the Affordable Care Act's goal of near-universal coverage, policymakers must understand why some people are enrolling in the law's marketplace plans or in Medicaid coverage and why others are not. This analysis of the survey finds that affordability--whether real or perceived--is playing a significant role in adults' choice of marketplace plans and the decision whether to enroll at all. People who have gained coverage report significantly more positive experiences shopping for health plans than do those who did not enroll. Getting personal assistance--from telephone hotlines, navigators, and insurance brokers, among other sources--appears to make a critical difference in whether people gain health insurance
Asunto(s)
Conducta de Elección , Participación de la Comunidad/estadística & datos numéricos , Intercambios de Seguro Médico/economía , Cobertura del Seguro/economía , Adulto , Planes Médicos Competitivos , Honorarios y Precios , Encuestas de Atención de la Salud , Intercambios de Seguro Médico/estadística & datos numéricos , Humanos , Medicaid/economía , Medicaid/estadística & datos numéricos , Patient Protection and Affordable Care Act , Estados Unidos , Adulto JovenRESUMEN
Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults.
Asunto(s)
Participación de la Comunidad , Planes de Asistencia Médica para Empleados/economía , Encuestas de Atención de la Salud , Intercambios de Seguro Médico/economía , Adulto , Honorarios y Precios , Humanos , Renta , Patient Protection and Affordable Care Act , Estados UnidosRESUMEN
The latest Commonwealth Fund Affordable Care Act Tracking Survey finds the share of uninsured working-age adults was 13 percent in MarchMay 2015, compared with 20 percent just before the major coverage expansions went into effect. More than half of adults who currently have coverage either through the Affordable Care Act's (ACA's) marketplace plans or Medicaid expansion were uninsured prior to gaining coverage. Of those, more than 60 percent lacked coverage for one year or longer. More than six of 10 adults who used their new plans to obtain care reported they could not have afforded or accessed it previously. Majorities of people with ACA coverage who have used their plans express satisfaction with the doctors covered in their networks and are able to find physicians with relative ease. Wait times to get appointments with physicians in marketplace plans and Medicaid are comparable to those reported by other working-age adults.
Asunto(s)
Intercambios de Seguro Médico , Cobertura del Seguro/estadística & datos numéricos , Medicaid/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Predicción , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Renta , Pacientes no Asegurados/estadística & datos numéricos , Persona de Mediana Edad , Patient Protection and Affordable Care Act , Estados UnidosRESUMEN
New estimates from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that 23 percent of 19-to-64-year-old adults who were insured all year--or 31 million people--had such high out-of-pocket costs or deductibles relative to their incomes that they were underinsured. These estimates are statistically unchanged from 2010 and 2012, but nearly double those found in 2003 when the measure was first introduced in the survey. The share of continuously insured adults with high deductibles has tripled, rising from 3 percent in 2003 to 11 percent in 2014. Half (51%) of underinsured adults reported problems with medical bills or debt and more than two of five (44%) reported not getting needed care because of cost. Among adults who were paying off medical bills, half of underinsured adults and 41 percent of privately insured adults with high deductibles had debt loads of $4,000 or more.
Asunto(s)
Deducibles y Coseguros/economía , Cobertura del Seguro/economía , Seguro de Salud/economía , Pacientes no Asegurados/estadística & datos numéricos , Adulto , Deducibles y Coseguros/legislación & jurisprudencia , Deducibles y Coseguros/tendencias , Predicción , Costos de la Atención en Salud , Encuestas de Atención de la Salud , Humanos , Renta , Persona de Mediana Edad , Estados UnidosRESUMEN
Across the country's four largest states, uninsured rates vary for adults ages 19 to 64: 12 percent of New Yorkers, 17 percent of Californians, 21 percent of Floridians, and 30 percent of Texans lacked health coverage in 2014. Differences also extend to the proportion of residents reporting problems getting needed care because of cost, which was significantly lower in New York and California compared with Florida and Texas. Similarly, lower percentages of New Yorkers and Californians reported having a medical bill problem in the past 12 months or having accrued medical debt compared with Floridians and Texans. These differences stem from a variety of factors, including whether states have expanded eligibility for Medicaid, the state's uninsured rate prior to the Affordable Care Act taking effect, differences in the cost protections provided by private health insurance, and demographics.
Asunto(s)
Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/estadística & datos numéricos , Adulto , Encuestas de Atención de la Salud , Humanos , Pacientes no Asegurados , Persona de Mediana Edad , Estados Unidos , Adulto JovenRESUMEN
New results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that the Affordable Care Act's subsidized insurance options and consumer protections reduced the number of uninsured working-age adults from an estimated 37 million people, or 20 percent of the population, in 2010 to 29 million, or 16 percent, by the second half of 2014. Conducted from July to December 2014, for the first time since it began in 2001, the survey finds declines in the number of people who report cost-related access problems and medical-related financial difficulties. The number of adults who did not get needed health care because of cost declined from 80 million people, or 43 percent, in 2012 to 66 million, or 36 percent, in 2014. The number of adults who reported problems paying their medical bills declined from an estimated 75 million people in 2012 to 64 million people in 2014.
Asunto(s)
Reforma de la Atención de Salud , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/tendencias , Cobertura del Seguro/economía , Cobertura del Seguro/tendencias , Adulto , Costos de la Atención en Salud/tendencias , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Renta , Cobertura del Seguro/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Persona de Mediana Edad , Patient Protection and Affordable Care Act , Adulto JovenRESUMEN
This analysis compares access to affordable health care across U.S. states after the first year of the Affordable Care Act's major coverage expansions. It finds that in 2014, uninsured rates for working-age adults declined in nearly every state compared with 2013. There was at least a three-percentage-point decline in 39 states. For children, uninsured rates declined by at least two percentage points in 16 states. The share of adults who said they went without care because of costs decreased by at least two points in 21 states, while the share of at-risk adults who had not had a recent checkup declined by that same amount in 11 states. Yet there was little progress in expanding access to dental care for adults, which is not a required insurance benefit under the ACA. Wide variation in insurance coverage and access to care persists, highlighting many opportunities for states to improve.
Asunto(s)
Accesibilidad a los Servicios de Salud/tendencias , Cobertura del Seguro/tendencias , Seguro de Salud/tendencias , Patient Protection and Affordable Care Act , Adolescente , Adulto , Niño , Preescolar , Atención Odontológica/estadística & datos numéricos , Costos de la Atención en Salud , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/legislación & jurisprudencia , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Lactante , Beneficios del Seguro/legislación & jurisprudencia , Cobertura del Seguro/economía , Cobertura del Seguro/legislación & jurisprudencia , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/economía , Seguro de Salud/legislación & jurisprudencia , Seguro de Salud/estadística & datos numéricos , Pacientes no Asegurados/legislación & jurisprudencia , Pacientes no Asegurados/estadística & datos numéricos , Persona de Mediana Edad , Pobreza , Estados UnidosRESUMEN
Looking at trends in private employer-based health insurance from 2003 to 2013, this issue brief finds that premiums for family coverage increased 73 percent over the past decade--faster than median family income. Employees' contributions to their premiums climbed by 93 percent over that time frame. At the same time, deductibles more than doubled in both large and small firms. Workers are thus paying more but getting less protective benefits. However, the study also finds that while premiums continued to rise through 2013, the rate of growth slowed between 2010 and 2013, following implementation of the Affordable Care Act. While families experienced slower growth in premium contributions and deductibles over this period, sluggish growth in median family income means families are paying more in premiums and deductibles as a share of their income than ever before.
Asunto(s)
Planes de Asistencia Médica para Empleados/economía , Planes de Asistencia Médica para Empleados/legislación & jurisprudencia , Planes de Asistencia Médica para Empleados/tendencias , Reforma de la Atención de Salud/economía , Reforma de la Atención de Salud/legislación & jurisprudencia , Cobertura del Seguro/economía , Cobertura del Seguro/legislación & jurisprudencia , Cobertura del Seguro/tendencias , Patient Protection and Affordable Care Act/economía , Seguro de Costos Compartidos/economía , Seguro de Costos Compartidos/legislación & jurisprudencia , Seguro de Costos Compartidos/tendencias , Predicción , Humanos , Estados UnidosRESUMEN
Whether they have health insurance through an employer or buy it on their own, Americans are paying more out-of-pocket for health care now than they did in the past decade. A Commonwealth Fund survey fielded in the fall of 2014 asked consumers about these costs. More than one of five 19-to-64-year-old adults who were insured all year spent 5 percent or more of their income on out-of-pocket costs, not including premiums, and 13 percent spent 10 percent or more. Adults with low incomes had the highest rates of steep out-of-pocket costs. About three of five privately insured adults with low incomes and half of those with moderate incomes reported that their deductibles are difficult to afford. Two of five adults with private insurance who had high deductibles relative to their income said they had delayed needed care because of the deductible.
Asunto(s)
Deducibles y Coseguros/economía , Financiación Personal/economía , Costos de la Atención en Salud/legislación & jurisprudencia , Reforma de la Atención de Salud/economía , Beneficios del Seguro/economía , Cobertura del Seguro/economía , Seguro de Salud/economía , Sector Privado/economía , Adulto , Deducibles y Coseguros/legislación & jurisprudencia , Deducibles y Coseguros/estadística & datos numéricos , Financiación Personal/legislación & jurisprudencia , Planes de Asistencia Médica para Empleados/economía , Planes de Asistencia Médica para Empleados/legislación & jurisprudencia , Costos de la Atención en Salud/estadística & datos numéricos , Reforma de la Atención de Salud/legislación & jurisprudencia , Encuestas de Atención de la Salud , Humanos , Renta , Beneficios del Seguro/legislación & jurisprudencia , Beneficios del Seguro/estadística & datos numéricos , Cobertura del Seguro/legislación & jurisprudencia , Cobertura del Seguro/estadística & datos numéricos , Seguro de Salud/legislación & jurisprudencia , Seguro de Salud/estadística & datos numéricos , Pacientes no Asegurados/legislación & jurisprudencia , Pacientes no Asegurados/estadística & datos numéricos , Persona de Mediana Edad , Patient Protection and Affordable Care Act/legislación & jurisprudencia , Sector Privado/legislación & jurisprudencia , Estados UnidosRESUMEN
By the end of the first open enrollment period for coverage offered through the Affordable Care Act's marketplaces, increasing numbers of people said they found it easy to find a plan they could afford, according to The Commonwealth Fund's Affordable Care Act Tracking Survey, April-June 2014. Adults with low or moderate incomes were more likely to say it was easy to find an affordable plan than were adults with higher incomes. Adults with low or moderate incomes who purchased a plan through the marketplaces this year have similar premium costs and deductibles as adults in the same income ranges with employer-provided coverage. A majority of adults with marketplace coverage gave high ratings to their insurance and were confident in their ability to afford the care they need when sick.