Commonwealth Study Covers The Underinsured
A very important study from The Commonwealth Fund found that close to a quarter of people who have health coverage are underinsured. This is consistent with other findings that put the number of uninsured and underinsured at about 85 million Americans. In essence, the underinsured are Americans that have coverage but, in many ways, have a hard time accessing the benefits due to high out-of-pocket costs. In my book, The Healthcare Labyrinth (available at this site), I discuss that affordable universal access is needed to address both the uninsured and underinsured crisis.
The Commonwealth Fund polled a national sample of adults aged 18 to 64 and found that 23% are underinsured. Most (about 66%) are in employer-sponsored health plans. About 14% were in individual or Exchange plans and 11% were in Medicaid. About 57% who were underinsured said they skipped care because of the cost. About 44% said they have medical debt.
With regard to Exchange coverage, if premium subsidy enhancements are not renewed as of 2026 annual premium costs for consumers will increase by an average of $705 a year and an estimated 4 million people could lose their coverage. A Kaiser Family Foundation (KFF) study confirms the premium change.
The Commonwealth study recommends a series of policies that could address healthcare affordability, including:
- Fully expand Medicaid. There are 10 states that have yet to expand. In the interim, allow citizens access to the Exchanges.
- Make the enhanced premium tax credits for the Exchanges permanent.
- Bar medical debt from credit reports and reform hospital billing.
- Lower deductibles and out-of-pocket expenses for Exchange plans.
- Further expand continuous Medicaid coverage for 12 months.
Additional articles: https://www.modernhealthcare.com/insurance/aca-subsidies-extension-commonwealth-fund and https://www.kff.org/interactive/how-much-more-would-people-pay-in-premiums-if-the-acas-enhanced-subsidies-expired/
(Some articles may require a subscription.)
#uninsured #underinsured #coverage #healthcare #healthinsurance #exchanges #aca #obamacare #employercoverage
CA Wants More Spent On Primary Care
The California Office of Health Care Affordability has set a target of spending 15% of all healthcare expenditures on primary care. Primary care is 35% of all visits but just 5% of all expenditures. About 7% of expenditures in CA right now are on primary care. Other states have set primary care spending targets.
#physicians #primarycare #healthcare
What Could Happen to Medicaid?
Good article on what could happen to Medicaid under a Trump administration. While it is early to say, Medicaid could face cuts as the tax extension begins and because Medicare and Social Security are largely off the table. On the regulatory front, work requirements could be embraced and that could impact coverage.
More radical changes would mean block grants to states and the end to the entitlement.
#medicaid #healthcare #coverage
https://thehill.com/policy/healthcare/5000935-medicaid-cuts-potential-next-congress
— Marc S. Ryan
