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Why some families with insurance still can't afford health care

Hospital bed
A hospital room in Maine. Photo: Shawn Patrick Ouellette/Portland Press Herald via Getty Images

Bloomberg has a good look at one of the most significant yet under-appreciated trends in health insurance: the dramatic increase in deductibles, especially within employer-based coverage.

By the numbers: In employer-based health plans, the average deductible for a single person is roughly $1,500, according to Kaiser — almost three times higher than it was a decade ago.

The impact: The trend toward increasingly high deductibles means families can still struggle to afford their care, even with insurance. Bloomberg’s story follows a family who has insurance, but declared bankruptcy twice amid mounting out-of-pocket bills.

What they’re saying: Now, experts are starting to reconsider whether high cost-sharing — once conceived as a way to turn employees into more discerning health care consumers — is working.

  • “High-deductible plans do reduce health-care costs, but they don't seem to be doing it in smart ways,” USC professor Neeraj Sood told Bloomberg.

Why it matters: This frustration with existing cost-shifting tools — and the growing sense that we’ve basically maxed out their utility — is contributing to the renewed focus on underlying health care prices.

  • Many employers don’t feel they can shift any more costs onto their workers, but that’s largely how they’ve kept premiums in check for the past several years. And they certainly don’t want to shoulder higher bills themselves.
  • As that frustration mounts, expect to see a greater political appetite for real cost controls.
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