Tag Archives: underinsured

Being ‘underinsured’ another measure of health coverage

A recent Commonwealth Fund report shows that the rate of Americans who are underinsured reached 41 percent last year, up from 12 percent in 2003. The fund defines an underinsured person as having been insured all year but with out-of-pocket costs (excluding premiums) of 10 percent or more of income; out-of-pocket costs, excluding premiums, equal to 5 percent or more of income if low-income; or deductibles equal to 5 percent or more of income.

The Commonwealth Fund

This year the rate of those who are uninsured has risen steadily, as the Gallup Sharecare Well Being Index shows. In the third quarter, the share of Americans without health insurance was 12.3 percent, according to Gallup’s most recent quarterly report.

After President Donald Trump announced that he would end cost-sharing subsidies under the Affordable Care Act (ACA), Danielle Wiener-Bronner covered the story for CNN and Jeffrey Young wrote about it for The Huffington Post. Continue reading

MMWR: Mass. reform narrowed insurance gap

Studying data from the Massachusetts Behavioral Risk Factor Surveillance System has led researchers to conclude that health care legislation in that state has narrowed the gap in insurance coverage for underserved populations. The data did show that “some groups continue to experience lower rates of annual checkup and less access to a personal care provider.”

The percentage of respondents who reported having health insurance rose 5.5%, from 91.3% in the pre-law period to 96.3% in the post-law period.

The report, “Short-Term Effects of Health-Care Coverage Legislation — Massachusetts, 2008” is in the March 12 issue of the CDC’s Morbidity and Mortality Weekly Report.

Underinsured face higher bills, bankruptcy

In Time, Karen Tumulty used the story of her brother’s kidney problems and resulting medical bills to look into the plight of the nation’s underinsured, who she said may be even more vulnerable than the uninsured because, “until a health catastrophe hits, they’re often blind to the danger they’re in.”

In a 2005 Harvard University study of more than 1,700 bankruptcies across the country, researchers found that medical problems were behind half of them — and three-quarters of those bankrupt people actually had health insurance.

Tumulty’s brother, Patrick Tumulty, renewed a short-term private policy for about six years. When his kidneys failed, his insurance company refused coverage because his problems were, in terms of his latest six-month short-term plan, a pre-existing condition. Even with the help of a country program for the uninsured, Patrick struggled to pay the resulting bills.

A paradox of medical costs is that people who can least afford them — the uninsured — end up being charged the most. Insurance companies, with large numbers of customers, have the financial muscle to negotiate low rates from health-care providers; individuals do not. Whereas insured patients would have been charged about $900 by the hospital that performed Pat’s biopsy (and pay only a small fraction of that out of their own pocket), Pat’s bill was $7,756. For lab work — and there was a lot of it — he was being charged as much as six times the price an insurance company would pay.


Talking Health: Covering the Underinsured – This webcast explores the growing problem of the underinsured.

The program, moderated by AHCJ board president Trudy Lieberman, features Continue reading

Three health-care issues Obama, Congress will face

The NewsHour with Jim Lehrer recently ran three stories about some of the health care challenges that President-elect Obama and Congress are facing.

In part one, correspondent Betty Ann Bowser looks at people who are underinsured in Nashville, Tenn. She found a 40 percent increase in patients who have canceled appointments with a cardiology practice, many of whom are insured. She reports that people who are underinsured are delaying care, putting off tests and treatments, skipping doses of prescription medications or just not filling the prescriptions.

In part two, Bowser reports from Massachusetts on the shortage of primary care doctors. Among the reasons medical student cite for looking at other specialties: lower pay for primary care doctors makes it hard to pay off large student loans, primary care doctors are overworked and having to spend time dealing with insurance issues.

In the last part of the series, Bowser goes to Kansas to report on small businesses and the difficulties they face in providing health insurance to workers. Climbing costs have led many workers to look elsewhere for insurance, leaving the pool of workers in plans with very few young, healthy people. Businesses are finding they have to offer less coverage at a higher cost.