Not enough insurance
Underinsured swamped by rising health care costs
 

Health policy experts acknowledge that the likelihood of major health care reform is significantly higher now than it was when Hillary Clinton led an unsuccessful effort to overhaul the nation’s health care system in 1993. Almost 50 million Americans have no health insurance today, an unprecedented social safety net failure among developed nations.

But many of those same experts aren’t certain if the movement to fix the inefficient and unfair U.S. system has attained the critical mass of public support needed to overcome the entrenched opposition of special interest groups, which retain powerful allies in Congress.

If there is a tipping point at which voter demand for fundamental health care reform becomes impossible for Congress to ignore, it will likely occur when middle-class families with health insurance find themselves unable to afford needed care. Evidence that the nation is moving steadily closer to that tipping point came this week in a startling new study by the Commonwealth Fund, a private, nonpartisan foundation specializing in health research.

Almost one of every five adults younger than age 65 with health insurance — 25 million Americans — did not have sufficient coverage to avoid financial hardship. That’s a 60 percent increase in the number of underinsured working-age adults in just four years, according to the Commonwealth Fund report.

Researchers defined underinsured as middle-class individuals whose out-of-pocket medical expenses after insurance payments reached at least 10 percent of their income. Lower-income individuals below 200 percent of the federal poverty level qualified as underinsured if they spent more than 5 percent of income on out-of-pocket costs.

Being underinsured also means paying deductibles of 5 percent or more of family income.One quarter of underinsured people had deductibles of $1,000 or more.

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