ACA plans don't address the underinsurance problem

The Affordable Care Act was intended to reduce the number of uninsured consumers, but it hasn't required payers to address the underinsured consumers who have coverage but still must pay substantial out-of-pocket costs, according to a New York Times Upshot column.

In fact, the number of underinsured consumers has actually increased by 80 percent since 2003 to 2010.

And underinsured people are more likely to skip needed care. A recent Commonwealth Fund survey found that 29 percent of people with health coverage have a deductible so high they skipped a test, treatment or follow-up appointment. Another 27 percent opted not to see a doctor when sick, and 23 percent didn't get a preventive care test.  

Additionally, a new Gallup poll just concluded that one in three Americans have delayed medical care because they cannot afford it, representing the highest number in 14 years. And this trend is on the rise for people with private insurance, FierceHealthPayer previously reported.

"In the quest for universal coverage, it's important that we not lose sight of 'coverage' in order to achieve 'universal,'" Aaron Carroll, professor of pediatrics at Indiana University School of Medicine, wrote in the column. "The point of improving access is, after all, to make sure that people can get, and afford, care when they need it."

What's more, the rate of underinsured may increase if insurers are allowed to sell copper plans on the health insurance exchanges. America's Health Insurance Plans, along with several lawmakers, want to introduce a new copper level that would feature lower premiums and higher up-front costs for consumers. 

Although the lower premiums could motivate more people to buy the copper plans, suggested the article, some consumer advocates worry that the high out-of-pocket costs would lead to a larger underinsured population that delays care.

To learn more:
- read the New York Times column