health insurance articles 2020
Washington, DC 20006, © 2021 The Commonwealth Fund. Can I buy my own health insurance? Most of this group had employer coverage (data not shown). The survey consisted of telephone interviews in English and Spanish and was conducted among a random, nationally representative sample of 4,272 adults ages 19 to 64 living in the continental United States. The adult uninsured rate was 12.5 percent. The average annual cost of a health plan ⦠In the first half of 2020, 43.4 percent of adults were inadequately insured. 10. Statistical results are weighted to correct for the stratified sample design, the overlapping landline and cellular phone sample frames, and disproportionate nonresponse that might bias results. The survey has an overall maximum margin of sampling error of +/â 2.0 percentage points at the 95 percent confidence level. healthinsurance.org. The pandemic has increased the need for access to mental and behavioral health services, Mr. Claxton said, but the networks offered by insurers often have very limited choices. Health ⦠As more Americans lose their jobs due to the pandemic, they also lose their health insurance tied to their employment. > Underinsured estimates, rates, full population of 19-to-64-year-old adults, > Underinsured estimates, millions, full population of 19-to-64-year-old adults, > Underinsured estimates, rates, 19-to-64-year-old adults insured all year with private insurance. The Kaiser research also highlights a concern that has most likely intensified during the pandemic: the limited availability of mental health providers within the typical insurance network. Covid-19 and the Need for Health Care Reform The patchwork way we govern and pay for health care in the United States is unraveling in this time of crisis, leaving millions of people vulnerable ⦠Young adults also reported high rates of being uninsured. In all, 400 interviews were conducted with respondents on landline telephones and 3,872 interviews were conducted on cellular phones. Medicare . Individual and Family . Commonwealth Fund Biennial Health Insurance Survey, 2020. Because there were an estimated 122 million working-age people in employer plans, compared to just 15 million in the individual market, there were far more underinsured people with employer coverage than with individual market insurance.3 The growth in the underinsured since 2010 has been driven by increasingly inadequate coverage in employer health plans. The corrected 2018 estimate is 21.3% [19.8, 22.9], The 2018 estimate was 43.8 million [40.5, 47.1], The corrected 2018 estimate is 41.4 million [38.2, 44.5], The 2020 estimate is 41.1 million [37.8, 44.5], The 2018 estimate was 29.7 percent [27.3, 32.2], The corrected 2018 estimate is 27.5 percent [25.2, 30.0], The 2020 estimate is 27.6 percent [25.2, 30.1]. Only 67 percent of employers surveyed indicated they were satisfied with the choices of mental health providers available under their plan, compared with 83 percent who were satisfied with their overall selection of doctors and hospitals. Latest news, headlines, analysis, photos and videos on Health Insurance | Sign up for the Science Times newsletter. The sample was designed to generalize to the U.S. adult population and to allow separate analyses of responses from low-income households. Rural hospitals are closing, many in states that havenât expanded Medicaid. Those with incomes under 250 percent of poverty ($31,900 for an individual and $65,500 for a family of four in 2020) are eligible for marketplace plans with reduced cost-sharing, including lower deductibles. Linda J. Blumberg et al., Comparing Health Insurance Reform Options: From âBuilding on the ACAâ to Single Payer (Commonwealth Fund and Urban Institute, Oct. 2019). The majority of people in this group had employer coverage (data not shown). Linda J. Blumberg et al., Comparing Health Insurance Reform Options: From âBuilding on the ACAâ to Single Payer (Commonwealth Fund and Urban Institute, Oct. 2019). In 2010, only 7 percent of people in private plans had deductibles that amounted to 5 percent or more of income. Of this group, only half (53%) met the definition of underinsured (data not shown). (See âHow We Conducted This Studyâ for more detail.) The high cost of health care is persisting during the pandemic, even for people lucky enough to still have job-based insurance. Jessica Banthin et al., Changes in Health Insurance Coverage Due to the COVID-19 Recession (Urban Institute, July 2020). 8. Roger D. Beyer, M.D. The Access to Health Services topic area encompasses 3 components: coverage, services, and timeliness. The data are weighted to the U.S. adult population by age, sex, race/ethnicity, education, household size, geographic region, population density, and household telephone use, using the U.S. Census Bureauâs 2019 Current Population Survey. 11. =In 2010, the survey was conducted from July 14 to November 30, 2010, among 3,033 adults ages 19 to 64; in 2012, the survey was conducted from April 26 to August 19, 2012, among 3,393 adults ages 19 to 64; in 2014, the survey was conducted from July 22 to December 14, 2014, among 4,251 adults ages 19 to 64; in 2016, the survey was conducted from July 12 to November 20, 2016, among 4,186 adults ages 19 to 64; and in 2018, the survey was conducted from June 27 to November 11, among 4,225 adults ages 19 to 64. While premiums rose only slightly from the 2019 survey, the increase in premiums and deductibles together over the last decade has far outpaced both inflation and the growth in workersâ earnings. Among those who reported any medical bill or debt problem, 37 percent said they had used up all their savings to pay their bills, 40 percent had received a lower credit rating as a result of their medical debt, 31 percent racked up debt on their credit cards, and one-quarter were unable to pay for basic necessities such as food, heat, or rent. These findings are also statistically unchanged from 2018. A combination of landline and cellular phone random-digit dial (RDD) samples was used to reach people. About 157 million Americans had coverage from their employer before the pandemic, but millions have lost their insurance along with their jobs over the past several months. This is statistically unchanged from the last time we fielded the survey in 2018. 13. We also report estimates from the 2010, 2012, 2014, 2016, and 2018 Commonwealth Fund Biennial Health Insurance Surveys. We revised our 2018 estimate of underinsured adults, after identifying a coding error in the measure for that year. 2020): 379â86; Ezekiel J. Emanuel and Abbe R. Gluck, The Trillion Dollar Revolution (Public Affairs, 2020); and David Blumenthal, Sara R. Collins, and Elizabeth J. Fowler, âThe Affordable Care Act at 10 Yearsâ¯â Its Coverage and Access Provisions,â New England Journal of Medicine, published online Feb. 26, 2020. their deductible constitutes 5 percent or more of household income. According to eHealthâs âHalf-Timeâ Report, the average cost of a monthly premium for 2020 health insurance coverage for a family was $1,134 as of November of 2019. How must is health insurance per month for a family? March 05, 2020 Benefits of health insurance for families and individuals A person is healthy if he has a healthy mind with a healthy body. That is more than twice as high as it was in 2010, when the average for a single person was $646, according to the foundation. Paying off accumulated medical debt over time can have a major impact on peopleâs lives. 5. Insurers join marketplaces or expand coverage areas in about half the states. October 29, 2020. Learn More. Buy now â during open enrollment. Oct. 8, 2020 The high cost of health care is persisting during the pandemic, even for people lucky enough to still have job-based insurance. 1. The surveys through 2016 were conducted by Princeton Survey Research Associates International using the same stratified sampling strategy that was used in 2018 and 2020 by SSRS. Even though their income combined with their insurance deductible and out-of-pocket spending didnât meet the threshold for underinsurance, they still struggled with medical bills. By 2016, that share was 15 percent. U.S. Census Bureau, Design and Methodology: Current Population Surveyâ¯â Americaâs Source for Labor Force Data, Technical Paper 77 (Census Bureau, Oct. 2019). Half of adults who spent any time uninsured and those who were underinsured reported problems paying medical bills or said they were paying off medical debt over time. Skip to content. This group is made up of people who were uninsured at the time of the survey (12.5%), were insured but had experienced a coverage gap in the past year (9.5%), or were insured continuously but had such high out-of-pocket costs or deductibles relative to their income that they were effectively underinsured (21.3%).1 (See box above.). Read More. ⢠Private health insurance coverage was more prevalent than public coverage, covering 68.0 and 34.1 percent of the population at some point during the year, respectively. Half of adults who spent any time uninsured or who were underinsured reported problems paying medical bills or said they were paying off medical debt over time. Private health insurance through the nation's public exchanges is set to become more affordable â at least for a couple of years. their out-of-pocket costs, excluding premiums, over the prior 12 months are equal to 10 percent or more of household income; or, their out-of-pocket costs, excluding premiums, over the prior 12 months are equal to 5 percent or more of household income for individuals living under 200 percent of the federal poverty level ($25,520 for an individual or $52,400 for a family of four in 2020); or. Last monthâs survey kicked off discussions about the 2020 election and how Americans feel about the nationâs healthcare system. Jessica Banthin et al., Changes in Health Insurance Coverage Due to the COVID-19 Recession (Urban Institute, July 2020). Global Health Insurance Exchange (HIX) IT Market to Reach $5.2 Billion by 2027 Amid the COVID-19 crisis, the global market for Health Insurance Exchange (HIX) IT estimated at US$2.8 Billion ⦠National Center for Health Statistics, âAbout the National Health Interview Survey,â updated Jan. 16, 2019. 3 (Mar. But even adults who were insured all year and not underinsured had access issues: 23 percent reported at least one cost-related problem getting health care. As many as 43 million Americans could lose their health insurance in the midst of the coronavirus pandemic, ⦠It is important to note that our estimated uninsured rate has a margin of sampling error of +/â 1.3 percent and therefore, the true estimate is likely between 11.2 percent and 13.9 percent.2. [Like the Science Times page on Facebook. The survey also underscored how much workers with health insurance still have to spend out of pocket for their care. 4. Many experts expect more people to lose coverage in the coming months as companies lay off workers or drop their health benefits. Lack of adequate coverage makes it difficult for people to get the health ⦠The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented financial stress on most of the US health care system, including physician practices, emergency medical service systems, and hospitals. In the first half of 2020, 43.4 percent of U.S. adults ages 19 to 64 were inadequately insured. 7. The authors thank Robyn Rapoport, Rob Manley, and Jazmyne Sutton of SSRS, and David Blumenthal, Liz Fowler, Michelle Doty, Jesse Baumgartner, Barry Scholl, Chris Hollander, Deborah Lorber, Jen Wilson, and Paul Frame, all of the Commonwealth Fund. The RDD landline portion of the survey achieved a 7.7 percent response rate and the RDD cellular phone component achieved a 6.5 percent response rate. Among people who were insured all year in private health plans, people who were enrolled in plans they bought on their own in the individual market â either directly from an insurer or the Affordable Care Act (ACA) marketplaces â were underinsured at the highest rates. Short-term . A look at our most interesting Healthinsurance.com survey findings and news coverage in April 2020, including COVID-19 economic impact, updates & more. It uses three measures to gauge the adequacy of insurance coverage: The survey began on January 14, 2020 â just before the outbreak of the coronavirus pandemic in the United States. In this brief, we present findings from the Commonwealth Fundâs latest Biennial Health Insurance Survey, which assesses the extent and quality of coverage for U.S. working-age adults. In states that expanded Medicaid, individuals with annual income up to 133% of the federal poverty level ($16,971 for an individual and $34,846 for a family of four in 2020) are eligible ⦠The consequences of this error in 2018 are below. This is why the estimated uninsured rate has a smaller margin of sampling error. 6. Commonwealth Fund analysis of the 2020 QHP landscape data, HealthCare.gov, Apr. Despite the severity of the pandemic and the abrupt disruption in economic activity beginning in March, the survey did not find statistically significant changes in coverage from the last time it was conducted in 2018. Because of the dominance of employer coverage in U.S. health insurance, this overall rate has closely tracked that of people enrolled in employer plans. ... 2020. A study released Thursday showed that the cost of health insurance for Americans rose in 2020. People with incomes below 133 percent of the federal poverty level (i.e., $16,971 for an individual and $34,846 for a family of four in 2020) reported uninsured rates that were three times higher than adults with incomes at 400 percent of the poverty level or higher (i.e., $51,040 for an individual and $104,800 for a family of four). Health care remains a major theme in our national conversation. In addition, 9.5 percent of adults were insured but had a gap in coverage in the past year and 21.3 percent were underinsured. All Rights Reserved. Watch our new video to learn how Medicaid expansion could help these providers stay afloat. The revised 2018 estimates are not statistically different from the reported estimates. Cost-related problems getting needed care were higher among people with incomes below 133 percent of poverty compared to those with incomes of 400 percent of poverty or more (42% vs. 25%), and also among workers in small businesses of less than 20 employees compared to those in companies with 100 or more employees (42% vs. 31%) (data not shown). Did the Affordable Care Act Lower Americansâ Financial Barriers to Health Care? 14. Over the past decade, deductibles have grown both in prevalence and size. This can be maintained with a balanced diet, walk ⦠Edward R. Berchick, Jessica C. Barnett, and Rachel D. Upton, Health Insurance Coverage in the United States: 2018 (U.S. Census Bureau, Nov. 2019). The average annual cost of a health plan covering a family rose to $21,342 in 2020, according to the latest survey by the Kaiser Family Foundation, a nonprofit group that tracks employer-based coverage. ], Workers With Health Insurance Face Rising Out-of-Pocket Costs. The majority (67%) of adults who reported medical bill or debt problems said the person in their household who incurred the medical bill was insured when the care was provided (Table 5). Weâve conducted this survey since 2001. 2018); and Sara R. Collins et al., How the Affordable Care Act Has Improved Americansâ Ability to Buy Health Insurance on Their Own: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016 (Commonwealth Fund, Feb. 2017). People who reported problems paying medical bills experienced lingering financial problems including damage to their credit ratings and depleted savings. People with at least one health problem who were enrolled in higher-deductible plans were more likely to report that they had not filled a prescription or had skipped a dose of medication for their health problem than people with lower or no deductibles. The uninsured rate we found falls into the range of estimates of recent federal surveys conducted in 2018 and 2019 (11.7% and 13.7%, respectively.) Norris, Louise. These actual expenditures and the potential risk of expenditures, as represented by the deductible, are then compared with household income. Health insurance coverage helps patients gain entry into the health care system. Privacy Policy, International Health Care System Profiles, Revision to the 2018 Underinsured Estimate, Hidden Costs, Value Lost: Uninsurance in America. We also did not find significant changes in coverage adequacy between the months leading up to the pandemic and the months that followed, but this may change as the pandemic continues. We continue the conversation in our September survey and share more insights on previously discussed topics like telemedicine.. September Survey: Insights On Healthcare & The 2020 Presidential Election. The percentage of people with health insurance coverage for all or part of 2019 was 92.0 percent. NPR dives into the origins of employer-based health insurance in ⦠A Step-By-Step Guide to Buying Individual Health Insurance. October 15, 2020. Single workers paid $1,243 a year for employer-sponsored health insurance in 2020, according to Kaiser. The potential costs are particularly worrisome during the economic downturn as even people with coverage hesitate to spend money on a doctorâs visit. (See âRevision to the 2018 Underinsured Estimateâ for detail.) The Biennial Survey has a maximum margin of sampling error of +/â 2 percent at the 95 percent confidence interval. 15. Despite the pandemic, we find no statistically significant change in any of our measures of coverage adequacy from 2018. The Scoop: Health Insurance News OverviewâOctober 15, 2020. International Student Health Insurance International students should check with individual schools to see if they need health insurance in the U.S. Anayat Durrani Dec. 22, 2020 Fast free quotes on health insurance that fits your needs â and your budget . 9. Employers paid the rest of the $7,470 total premium. Medicaid . was sentenced to 57 months of incarceration for his involvement in a conspiracy to commit healthcare fraud. Commonwealth Fund Biennial Health Insurance Survey, ⦠In this analysis, we use a measure of underinsurance that accounts for an insured adultâs reported out-of-pocket costs over the course of a year, not including insurance premiums, as well as their plan deductible. 12. Employment-based insurance ⦠The definition does not include people who are at risk of incurring high costs because of other aspects of their planâs design, such as copayments or uncovered services. Sun 10 May 2020 06.00 EDT. That means they have to provide comprehensive benefits to all ⦠Workers paid about a quarter of the total premiums, or $5,588, on average, with their employers picking up the rest of the cost. But rates also were high among people with coverage all year who were not underinsured: one-quarter reported medical bill problems or debt. The Commonwealth Fundâs measure of underinsurance includes how much people spent out of pocket in the past year and the size of their deductible, both calculated as a share of their income. This was two or more times higher than comparison groups. https://doi.org/10.26099/6aj3-n655, Delivery System Reform, Vulnerable Populations, Uninsured, Coverage and Access, Underinsured, Private Insurance, Biennial Health Insurance Survey, Employer Health Insurance, Health Insurance Marketplace, 1666 K Street, NW, Suite 1100
âNothing changed much, but then everything changed,â said Gary Claxton, a senior vice president at the foundation. Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2018, Americansâ Views on Health Insurance at the End of a Turbulent Year, How the Affordable Care Act Has Improved Americansâ Ability to Buy Health Insurance on Their Own: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016, Interim Economic Projections for 2020 and 2021, Changes in Health Insurance Coverage Due to the COVID-19 Recession, Comparing Health Insurance Reform Options: From âBuilding on the ACAâ to Single Payer, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, JanuaryâJune 2019, About the National Health Interview Survey, Health Insurance Coverage in the United States: 2018, Design and Methodology: Current Population Surveyâ¯â Americaâs Source for Labor Force Data, The Continuing Threat to the ACA and Health Care Reform, if they have insurance, whether they experienced a gap in coverage in the prior year. Robin A. Cohen et al., Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, JanuaryâJune 2019 (National Center for Health Statistics, May 2020). More than one-third of Latino adults, workers in small businesses (i.e., fewer than 20 employees), and adults with low incomes were either uninsured at the time of the survey or spent some time uninsured in the past year (Table 1). Among those paying off debt over time, more than half (54%) had incurred debt of $2,000 or more. (For family coverage, ⦠The share of the adult population in private health plans with deductibles of $1,000 or more doubled between 2010 and 2020. 11. The survey was conducted from January through July of this year, making it hard for the researchers to see how the changed circumstances will affect costs and employersâ willingness to pay for coverage. More than one-third (35%) of all adults reported at least one cost-related problem getting needed health care in the past year including not filling a prescription; skipping a recommended test, treatment or follow-up visit; not going to a doctor when sick; or not getting needed specialist care. Coverage. Health Insurance Marketplace Fraud: Call the Health Insurance Marketplace Call Center at (800-318-2596, or TTY 855-889-4325 if: Someone other than the insurance company youâve chosen contacts you about health insurance and asks you to pay â or asks for your financial or personal health ⦠But people with incomes over that threshold see higher deductibles, which ranged as high as $8,150 for silver-level plans in the 38 states where the federal government operated the marketplaces in the 2020 plan year.4. Analysis of the 2019 Current Population Survey by Sherry Glied and Ougni Chakraborty of New York University for the Commonwealth Fund. While employers and insurers have made use of telemedicine during the crisis to provide workers better access to therapists and medicine, Mr. Claxton said, it is unclear whether these options will become permanent. In the first article in this series, Schulman and Milstein 21 discuss the implications of proposals that advocate for a âMedicare for allâ approach for US health insurance as it would relate to ⦠Commonwealth Fund Biennial Health Insurance Survey11, National Health Interview Survey (NHIS) (Jan.âJune 2019)12, Multistage area probability design; personal household interviews13, Probability-selected sample; personal and telephone interviews15. Benjamin Rasmussen for The New York Times, Many experts expect more people to lose coverage, hesitate to spend money on a doctorâs visit. People in private health plans who were insured all year with deductibles of $1,000 or more were significantly more likely than those with lower or no deductibles to report problems paying medical bills or said they were paying off medical debt over time. The survey indicates that deductibles alone are associated with financial problems and may impact peopleâs decisions about whether to get needed health care. 2. Munira Z. Gunja and Sara R. Collins, Who Are the Remaining Uninsured, and Why Do They Lack Coverage? Since 2010, premiums have climbed 55 percent, more than double the rise in wages or inflation, according to the foundationâs analysis. In the 2018 Biennial Survey, two nonresponse categories in a question used to gather income information (those earning more than $35,000) were recoded during questionnaire development without a corresponding adjustment to the created variable that underlies the underinsured measure. As estimates get further from 50 percent in either direction, the margin of sampling error decreases. Open enrollment is your annual opportunity to shop for ACA-compliant health ⦠âHealth insurance is an enormous cost for small businesses,â said Amanda Ballantyne, the executive director of the Main Street Alliance, an advocacy group for small businesses. 3. More than 43 percent of working-age adults had inadequate health insurance when the COVID-19 pandemic hit, a new Commonwealth Fund survey finds, Policy inaction combined with the COVID-19 pandemic could create an affordability crisis in American health care. But it does show a persistent vulnerability among working-age adults in their ability to afford coverage and health care that could worsen if the economic downturn continues. Noncoverage-related barriers to care include structural racism in the health care system, lack of provider capacity such as in rural areas, and, most recently because of the pandemic, fear. In addition to paying for their share of premiums, most employees face a hefty deductible â an average of $1,644 for an individual. There was no statistically significant change in coverage inadequacy between the months leading up to the pandemic and the months that followed, but this may change as the pandemic continues. People who were underinsured were particularly affected: nearly half (48%) said they had used up all their savings to pay off their bills (Table 5). Specifically, we consider people who are insured all year to be underinsured if: The out-of-pocket cost component of the measure is only triggered if a person uses their plan to obtain health care; it does not provide information about the plan design. By continuing on our website, you agree to our use of the cookie for statistical and personalization purpose. People with higher deductibles also were carrying higher debt loads: 62 percent of people with deductibles of $1,000 or more who said they were paying off medical debt had incurred debt of $2,000 or more compared to 46 percent of those with lower deductibles who owed payments for bills (Table 5). We are therefore revising the 2018 estimate as part of the release of this yearâs survey. Among demographic groups, Blacks were significantly more likely than whites to report problems with medical bills (45% vs. 35%), as were lower-income people (133% of poverty or lower) compared to people with higher incomes (400% of poverty or higher) (42% vs. 27%) (data not shown). Institute of Medicine, Hidden Costs, Value Lost: Uninsurance in America (National Academies Press, 2003). whether high out-of-pocket costs and deductibles are causing them to be underinsured, despite having continuous coverage throughout the year. People who get coverage in the individual market and ACA marketplaces face higher deductibles, on average, relative to their incomes, than people in employer plans. The 2020 estimate is unchanged at 21.3 percent, but with the margin of sampling error, could range from 19.7 to 23 percent. While insurance status is not the only determinant of whether a person has access to health care, it is the most important.5 Research has concluded that the ACAâs coverage expansions led to significant improvements in access over the past 10 years.6 But financial barriers to care remain in the U.S. because millions of people either lack insurance or have coverage with significant cost-sharing. Some employers and insurance companies waived cost-sharing during the early months of the pandemic, but some of them have started to reinstate deductibles and co-payments for care unrelated to the coronavirus.