New Health Insurance Survey: Post-ACA, Market Works Better For Consumers Buying Plans On Their Own; Fewer People Postponing Care and Medications Because of Cost
The Commonwealth Fund, February 1, 2017
The health insurance market has been working better for consumers buying coverage on their own, especially those with health problems, since the Affordable Care Act (ACA) took effect. According to a new Commonwealth Fund report, the percentage of people who shopped for insurance on their own who could not find an affordable plan dropped from 60 percent in 2010 to 34 percent in 2016.
“Before the Affordable Care Act, it was often extremely hard for people not covered through an employer to buy coverage,” said Sara Collins, vice president for Health Care Coverage and Access at the Commonwealth Fund and the report’s lead author. “Many were routinely turned down, told a preexisting condition would not be covered, or charged higher rates because of an illness. This survey finds that since the law was passed the individual market has changed dramatically. Now, millions of people are finding and buying affordable plans that provide coverage meeting their needs.”
The survey finds that since the ACA’s passage in 2010, people are more likely to say they can get the health insurance and care they need:
* In 2012, 80 million adults said they went without health care or medication they needed because of the cost, compared to 63 million in 2016.
* In 2010, more than two of five (43%) adults buying plans on their own said they found it difficult or impossible to find a plan that fit their needs, compared to one-quarter (25%) in 2016.
* In 2010, more than half (53%) of adults with health problems said it was difficult or impossible to find a plan that fit their needs; this fell to one-third (31%) in 2016. For people with low incomes, the share reporting such difficulty fell by about half, from 49 percent in 2010 to 26 percent in 2016.
* In 2012, 29 percent said they did not go to a doctor when they were sick because of the cost, compared to 20 percent in 2016. In 2012 over one-quarter of adults (27%) said they did not fill a prescription because of the cost, compared to one-fifth (19%) in 2016.
* In 2016, the share of adults reporting they had skipped a recommended test, treatment, or follow-up visit because of the cost fell to 18 percent, from 27 percent in 2012. And in 2016, 13 percent said they had not gotten needed care from a specialist because of the cost, down from 20 percent in 2012.
* Medical bills remain a challenge. The number of adults saying they had problems paying medical bills in the past 12 months or were paying off medical bills over time declined modestly, from 75 million is 2012 to 70 million in 2016. There are still a substantial number of people paying off medical debt over time; nearly 46 million adults reporting doing so in 2016—unchanged from 2012.
By Don McCanne, M.D.
It is really wonderful to see the progress that we have made with the Affordable Care Act in ensuring affordable health care for all. To understand better how far we have come, let’s select from this report the findings of where we stand today:
* Only 63 million adults say they went without health care or medication they needed because of the cost
* Only 25 percent of adults buying plans on their own say they found it difficult or impossible to find a plan that fit their needs
* Only 31 percent of adults with health problems say it was difficult or impossible to find a plan that fits their needs
* Only 26 percent of adults with low incomes and health problems say it was difficult or impossible to find a plan that fits their needs
* Only 20 percent of adults say they did not go to a doctor when they were sick because of the cost
* Only 19 percent of adults say they did not fill a prescription because of the cost
* Only 18 percent of adults reported they had skipped a recommended test, treatment, or follow-up visit because of the cost
* Only 70 million adults said they had problems paying medical bills in the past 12 months or were paying off medical bills over time
* Only 46 million adults are currently paying off medical debt over time (unchanged from 2012)
Is this really good enough? Should we vigorously defend the status quo supported by the Democrats? Or should we support Republican policies that would replace the Affordable Care Act – policies that would shift more costs to patients, inevitably increasing the exposure of adults to these difficulties they now face? These are the options currently under debate in Congress.
There is another option. We can reduce all of those numbers to ZERO simply by enacting and implementing a well designed single payer national health program – an improved Medicare for all. And it wouldn’t cost the nation any more than we are already spending. Congress and the President need to hear from us.