Study: A quarter of adults with coverage are underinsured

Nearly a quarter of U.S. adults who were insured all last year lacked adequate protection from big medical bills based on their income, according to Commonwealth Fund research (Source: “Study: 23 Pct of US Adults With Health Coverage Underinsured,” Associated Press via New York Times, May 20, 2015). 

The nonprofit foundation estimates that about 31 million, or 23 percent, of people between the ages of 19 and 64 were underinsured in 2014 due in part to the out-of-pocket expenses they have to pay for care.

Commonwealth considers most people to be underinsured if their out-of-pocket costs — a total that doesn't include the premium — equal 10 percent or more of their household income. The foundation uses a lower percentage for those with incomes close to federal poverty levels.

The share of continuously insured adults with high deductibles has tripled, rising from 3 percent in 2003 to 11 percent in 2014. Half (51%) of underinsured adults reported problems with medical bills or debt and more than two of five (44%) reported not getting needed care because of cost. Among adults who were paying off medical bills, half of underinsured adults and 41 percent of privately insured adults with high deductibles had debt loads of $4,000 or more.

The ACA expanded insurance to millions of U.S. residents last year, with many gaining coverage with help from income-based tax credits or subsidies. Commonwealth said it could not assess the overhaul's impact on underinsurance.