Search

Need new health insurance NOW?

If you experience certain life changes, you don’t have to wait for Open Enrollment in November to enroll in affordable health coverage on healthcare.gov or your state’s marketplace. You have 60 days after the following events to apply for a Special Enrollment Period and enroll:

• Moving to a new zip code or county
• Getting married or divorced
• Having a baby, adopting or becoming a foster parent
• Becoming a U.S. citizen or getting a green card

You have 60 days before or after the following to enroll: 

• Losing your health insurance from your job
• Turning 26 and aging off your parent’s health plan

And if you are experiencing domestic violence and want to apply for your own health plan, you can do so at any time.

Learn more about Special Enrollment Periods at healthcare.gov or call 1-800-318-2596.

 

Subscribe to our newsletter

Keep up with the latest actions and news!

Recent Articles
This area does not yet contain any content.
The journal that this archive was targeting has been deleted. Please update your configuration.
Navigation
« Big love for all our Raising Women’s Voices partners today! | Main | Women lead push to protect our health care! »
Thursday
Feb072019

Number of underinsured people is rising

More people are underinsured or have gaps in insurance coverage

A new study out today from the Commonwealth Fund flags a troubling trend: While the number of people with no health insurance has declined dramatically since 2010, when the Affordable Care Act (ACA) was signed into law, increasing numbers of American adults are underinsured. Underinsurance is growing fastest among adults with employer-sponsored health plans that have high deductibles. It is also rising among those who buy plans on the ACA marketplaces, but who are not eligible for premium subsidies or cost-sharing reductions.

What does underinsured mean and why are more people experiencing this problem? The Commonwealth Fund defines underinsured this way:

  • Having high out-of-pocket costs, excluding premium payments, equal to 10% or more of household income over the previous 12 months;
  • Having high out-of-pocket costs, excluding premiums, equal to  5% or more for households living under 200%  of the Federal Poverty Limit ($24,120 for an individual or $49,200 for a family of four).
  • Having high deductibles (equal to 5% or more of household income).

The  increase in the percentage of  underinsured people with health coverage through their jobs (up from 17% in 2010 to 28% in 2018 %) is most likely related to the trend among employers of increasing plan deductibles and co-pays to offset rising health care costs, the study suggests.  For those buying their own plans, such as through healthcare.gov and state-based insurance marketplaces, the problem is that people with incomes over 400% of the Federal Poverty Level ($48,240 for an individual or $98,400 for a family of four) are not eligible for federal premium subsidy assistance and reductions in the amount they have to pay for cost-sharing. So, people in this situation may choose ACA health plans with the lowest monthly premiums, but then are faced with high deductibles and other cost-sharing requirements.

The Commonwealth study, which was a telephone survey conducted from June to November of 2018, did not take into account the expanded sale of short-term “junk” health insurance plans made possible by new Trump administration rules that went into effect in November.  Those plans are not required to cover all of the benefits that are included in ACA plans, so people purchasing those plans may find themselves underinsured, facing considerable out-of-pocket costs.

Being underinsured, or having gaps in your coverage during the year, often means you will have trouble paying your medical bills, the study found.

Are women more affected by these trends? Unfortunately, the Commonwealth study did not provide gender breakouts.  But, we know from other studies that the highest growth in out-of-pocket health spending over the past few years has been among those who are younger, lower income and female.
 
What can be done to address these problems? The Commonwealth Fund study suggested that federal and state governments could enact policies to extend the ACA’s coverage gains and improve cost protections in ACA and employer-sponsored plans.  Examples of such efforts include expanding Medicaid in those states that have not yet done so, in order to cover more people with affordable plans, and limiting or banning the sale of those short-term junk plans (which are likely to be a bigger factor this year in causing underinsurance). Some states are also trying “reinsurance” policies that create a state fund to reimburse health plans for extraordinary expenses in treating seriously ill people, so that the plans do not pass on those costs to all enrollees. Some states are also examining the possibility of allowing people to buy into Medicaid plans, if they earn a little bit too much to qualify for Medicaid. The study findings may also help groups pushing for Medicare for all plans, since one of the chief objections to some of these proposals is that people will not want to lose their employer-sponsored health plans.

The study also recommended reinstating ACA marketplace navigator and outreach funding, to help people make choices of health plans that will not saddle them with unaffordable deductibles. That recommendation was issued on the same day the news broke about more ACA-related pages disappearing from websites operated by the U.S. Department of Health and Human Services (HHS).  Researchers from Sunlight, who have documented a series of quiet website content removals since the Trump administration took office, reported today that 10 pages about the Affordable Care Act and its benefits were taken down from the Office of Population Affairs website in early 2017 and the content has yet to be replaced.

Reader Comments

There are no comments for this journal entry. To create a new comment, use the form below.

PostPost a New Comment

Enter your information below to add a new comment.

My response is on my own website »
Author Email (optional):
Author URL (optional):
Post:
 
Some HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <code> <em> <i> <strike> <strong>