A new report from Families USA reveals that one in four Americans with non-group coverage—insured either through the health insurance exchanges or outside the health insurance exchanges—cannot afford their medical care. They are unable to pay the high deductibles or out-of-pocket costs their policies require. As a result, they go without care they need.
All told, 25.2 percent of people in non-group plans went without care because they were not able to pay for it. Not surprisingly, people with incomes between 139 and 249 percent of the federal poverty level had more trouble affording care (32.3%) than people with incomes between 250 and 399 percent of poverty (22.2%).
And almost three in ten people with deductibles of $1500 or more (29.8%) went without medical care as compared with about two in ten people with deductibles under $1500 (19.6%). A somewhat smaller percentage of people who got their coverage through the state exchanges had deductibles of $1500 or more (42.8%) than people who got their coverage outside the exchanges (58.3%).
More than one in five people had deductibles over $3000–22.5% of people covered through a state exchange and 37.5% covered outside the exchange. Interestingly, the percentage of people with no deductible jumped from 3.6 to 10.6 between 2013 and 2014.
The most common procedures people skipped were medical tests, treatments and follow-up visits (15.3%) and filling prescriptions (14.2%). Many prescription drugs have become prohibitively expensive even with insurance. Not only have prices on brand-name drugs gone up, but copays on brand-name drugs have risen signficantly, to as much as 30 percent of the cost. It’s no wonder that government drug price negotiation is a top policy issue for democrats and republicans alike.